Dysphagia
Dysphagia
Difficulty in swallowing can occur in severe throat infection. Most bad sore throats will cause some discomfort on swallowing but not true difficulty, and patients do not necessarily need referral unless there are other reasons for concern. If the patient has difficulty taking fluids or food, referral for medical assessment is warranted.
Dysphagia, when not associated with a sore throat, always needs referral.
Dysphagia can also happen when an abscess develops in the region of the tonsils (quinsy) as a complication of tonsillitis – see Image 1. On examination a large swelling can be seen at the back of the throat, often displacing the uvula from the mid-line. This will require an urgent hospital admission where an operation to drain the abscess may be necessary and high-dose parenteral antibiotics given.
Picture credit: James Heilman MD CC BY-SA 3.0 creativecommons.org/licenses/by-sa/3.0 via Wikimedia Commons
Reflection exercise
Think about how you will talk with the patient about the need to examine their lymph glands and appearance of the throat. Make a note of what you would actually say and do, including use of any necessary equipment.