Pharyngitis

Definition – inflammation of the pharynx or pharyngeal wall characterized by pain over pharynx (sore throat) Classification – Acute and chronic pharyngits

Acute pharyngitis Chronic pharyngitis It is of sudden onset Short duration It may be purulent or ulcerative Chronic pharyngitis Gradual onset Long duration of symptoms Due to persistent inflammation of the pharynx

If tonsillitis involves it is termed as pharyngotonsillitis Chronic pharyngitis are of 3 types Hypertrophic – characterized by general thickening and congestion of the pharyngeal mucous membrane Atrophic – the membrane is thin, whitish, glistening Granular – characterized by numerous swollen lymph follicles on the pharyngeal wall If tonsillitis involves it is termed as pharyngotonsillitis

Causes Majority of cases are due to an infectious organism acquired from contact with an infected individual Infectious causes Viral (40-80%) Adenovirus – lymph node enlargement will be there and severe throat pain Influenza – rapid onset of high temperature, headache and sore throat Epstein barr virus (mononucleosis) – marked redness and swelling and exudative tonsillitis Herpes simplex virus – mouth ulcers Measles ,Rhinovirus, coronavirus, RSV and HIV.

BACTERIAL GROUP A streptococcus (GAS) Streptococcus pneumoniae Haemophilus influenzae Bordetella pertusis Cornybacterium diphtheriae Arcanobacterium haemolyticum

Streptococcal pharyngitis or strep throat Group A beta hemolytic streptococcus (GAS) Most common bacterial cause. Fever, sore throat and large lymph nodes are the symptoms Contagious - infection spread by close contact Fungal causes Candida albicans – oral thrush

Non infectious Chemical irritation – smoking Thermal irritation Head and neck neoplasm Allergies , allergic rhinitis Gastroesophageal reflux disease

Signs and symptoms Sore throat, dry or scratchy throat Sneezing Runny nose Headache Fatigue Body aches Chills Fever

Strep throat can cause Trouble swallowing Red throat with white patches Swollen lymph nodes Fever Chills Loss of appetite and nausea Unusual taste in mouth General malaise

Diagnostic measures History collections Physical examination Throat swab – culture Blood tests – CBC RSAT – rapid streptococcal antigen test

Management Symptomatic treatment Analgesics – acetaminophen and NSAIDS Steroids (dexamethasone) acetaminophen – relieves pain Antibiotics – for bacterial infection Antiviral – for viral infection Antifungal – imidazole, triazole, thiazole

Complications Ear infection Sinusitis Abscess near the tonsils Rheumatic fever if strep throat is not treated Glomerulonephritis Scarlet fever

Home care Drinking plenty of fluids Lemon tea or tea with honey Fluid food rather than solid Gargling with warm salt water Using throat lozenges Using humidifier Proper rest Acetaminophen if needed to decrease pain

Prevention Avoid sharing food, drinks and eating utensils Hand washing after coughing or sneezing Use alcohol based hand sanitizers Avoid smoking