Croupous Pharyngitis.
Synonyms:—Membranous pharyngitis; pharyngitis crouposa.
Definition:—An acute, superficial inflammation of the mucous membranes of the pharynx, characterized by a false membrane, which develops with the desquamation of the epithelium.
Etiology:—This form of pharyngitis results from infection by the streptococcus pyogenes, or by the pneumococcus. It occurs in adults as well as in children, and in those of reduced general health, or those debilitated, who are exposed to damp, cold weather, in unhygienic localities, or who have been exposed to the contagion of severe epidemic disorders.
Symptomatology:—The patient has all the symptoms of a severe sore throat, with the initial malaise, chill, fever and general systemic disturbances, but the disturbance is not as severe as that of diphtheria, nor the subsequent debility as great as that following a severe case of tonsillitis.
Diagnosis:—The presence of the characteristic microorganism as above named, and the absence of the Klebs-Loeffler bacillus, with the pseudo membrane, determine the character of the disease. The mucous membrane is not deeply involved and deep ulceration does not occur. Upon forcible removal of the false membranes the tissues bleed quite readily, as in diphtheria. The membrane covers the mucous surface in small, thin, yellowish white patches, and there are small vesicles or minute ulcers beneath it. The absence of severe constitutional disturbance will assist in determining the character of the disease.
Prognosis:—These cases, if uncomplicated, invariably recover.
Treatment:—The premonitory chill and fever should be treated with aconite and phytolacca. The surfaces should be thoroughly washed with equal parts of hydrogen peroxid and water, and subsequently with distilled extract of hamamelis two parts, colorless hydrastis one part, water five parts. The use of four ounces of the infusion of white oak bark, to which a dram of potassium chlorate has been added, will be useful. In some cases soothing washes are required. Tonic treatment should be carefully adapted to each individual case.
