What are the causes of odynophagia (painful swallowing)?

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Differential Diagnosis for Red Flag Painful Swallowing

Single Most Likely Diagnosis

  • Acute Epiglottitis: This condition is characterized by inflammation of the epiglottis, which can cause severe pain when swallowing. It's a medical emergency due to the risk of airway obstruction.

Other Likely Diagnoses

  • Strep Pharyngitis: Caused by Group A beta-hemolytic streptococcus, this infection leads to severe throat pain and difficulty swallowing.
  • Peritonsillar Abscess: A collection of pus behind the tonsils, which can cause severe pain on one side of the throat, difficulty swallowing, and fever.
  • Esophageal Foreign Body: Objects lodged in the esophagus can cause sudden onset of severe pain when swallowing.

Do Not Miss Diagnoses

  • Cancer of the Esophagus or Throat: Although less common, cancers in these areas can present with progressive difficulty and pain when swallowing.
  • Retropharyngeal Abscess: A serious infection in the space behind the pharynx, which can lead to airway compromise if not promptly treated.
  • Epidural Abscess: An abscess in the epidural space surrounding the spinal cord, which can compress the spinal cord and lead to neurological deficits.

Rare Diagnoses

  • Esophageal Spasm: Abnormal contractions of the esophagus that can cause chest pain and difficulty swallowing.
  • Eosinophilic Esophagitis: A chronic immune system disease in which a type of white blood cell, the eosinophil, builds up in the esophagus in response to an allergen or irritant.
  • Caustic Esophageal Injury: Damage to the esophagus from ingesting corrosive substances, which can lead to chronic pain and difficulty swallowing.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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