Pharyngitis is an inflammation of the pharynx. which frequently results in a sore throat and
may be caused by a variety of microorganisms. Chronic pharyngitis is a chronic inflammation of
the pharyngeal mucous membrane and submucous Lymphoid tissues. In infectious pharyngitis, bacteria
or viruses may directly invade the pharyngeal mucosa, causing a local inflammatory response.
Causes
- Virus
- Adenovirus
- Arcanobacterium (Corynebacterium) haemolyticus
- Coxsackieviruses A and B
- Herpes Simplex virus
- HIV
- Influenza virus
- Mononucleosis
- Respiratory Syncytial virus
- Rhinovirus
- Bacteria
- Arcanobacteriumn
- Chlamydia pneumoniae
- Corynebacterium
- Group Ab Streptococcus
- Group C, G, and F Streptococci
- Mycoplasma pneumonia
- Neisseria gonorrhoeae
- Other causes of pharyngitis
- Oral thrush is due to candidal species (immunocompromised patients).
- Dry air, allergy/postnasal drip, chemical injury, gastroesophageal reflux disease (GERD), smoking, neoplasia, and endotracheal intubation.
Riak Factors
- Colder months-during respiratory disease season.
- Infected family member
Signs and Symptoms
- Sore throat
- Strep throat may be accompanied by fever, headache, swollen lymph nodes in the neck
- Viral pharyngitis may be associated with rhinorrhea and postnasal discharge
- Difficulty in swallowing and breathing
DIAGNOSIS
Differential Diagnosis
- Candidiasis
- Diphtheria
- Epiglottitis (adult)
- Gonorrhea
- Herpes Simplex
- Mononucleosis
- Pediatrics
- Croup or Laryngotracheobronchitis (pediatrics)
- Epiglottitis Pediatrics
- Hand-Foot-and-Mouth Disease (pediatrics)
- Pharyngitis (pediatrics)
- Scarlet Fever
- Peritonsillar abscess
- Pharyngitis Pneumonia
- Mycoplasma Retropharyngeal Abscess
- Rheumatic Fever
Investigation
- GABHS rapid antigen detection test
- Throat culture
- Antistreptolysin-O (ASO)
- Mono spot
- Peripheral smear
- Fluorescent monoclonal antibody test
- .Lateral neck film
- Chest X-ray
TREATMENT
Goal
- Decrease the duration of the illness and infective period
- Provide symptomatic relief
- Decrease the incidence of relapses and complications.
Non-Pharmacological Treatment
Viral infections are managed with supportive measures Such as warm saline gargles, analgesics, and fluids.
Pharmacological Treatment
Antibiotic therapy
- 1st line treatment: Penicillins, erythromycin
- 2nd line treatment: Penicillins, cephalosporins, macrolides
- Gonococcal pharyngitis: Ceftriaxone plus doxycycline or azithromycin, or ciprofloxacin plus doxycycline or azithromycin
PATIENT EDUCATION
- A complete full course of antibiotic therapy
- The risk of recurrence
- Regular follow-up
Complications
- Otitis media
- Mastoiditis
- Sinusitis
- Epiglottitis
- Pneumonia
Prognosis
- Most cases of pharyngitis resolve spontaneously within 10 days.
- Treatment failures are frequent (poor compliance, antibiotic resistance, untreated close contacts, carrier states, and antibiotic-related or co-pathogenic suppression of host immunity and necessary flora).