Pharyngitis – Definition, Cause, Types, Examples

Infection or inflammation of the Pharynx is known as PHARYNGITIS. It is a disease in which the throat is swollen and sore. Pharyngitis can be categorized into Acute and Chronic Pharyngitis

 Acute Pharyngitis (Sore Throat)

It is a sudden painful inflammation of the pharynx, the back portion of the throat that includes the posterior third of the back tongue, soft palate, and tonsils.

 Causes

• Environmental exposure to viral agents adenovirus, influenza virus, Epstein-Barr virus, and herpes simplex virus.
• Bacterial infection- 10% of adults with pharyngitis have group A Beta-hemolytic streptococcus (GABHS), Which is commonly referred to as group A streptococcus (GAS) OR streptococcal pharyngitis.
• When GAS causes acute pharyngitis, the condition is known as strep throat.
• Other bacterias mycoplasma pneumonia, Neisseria gonorrhea, and Influenza type B.
• Poorly ventilated rooms.
• Viral pharyngitis peaks during winter and early spring.
• Viral pharTREATMENT:
• Meningitis spreads easily in the droplets of coughs and sneezes.
• Unclean hands that have been exposed to the contaminated fluids.

Clinical Features

1. Pain-body, swallowing
2. Dry cough
3. Fever
4. Vasodilation 
5. Edema 
6. Redness and swelling in the tonsillar pillar, uvula, and soft palate.
7. A creamy exudate may be present in the tonsillar pillars 
8. Lymph node enlargement

Diagnosis

•  Hidtory collection 
• Physical examination 
• Culture and sensitivity test 
• Blood investigation
• Raspid Streptococcal Antigen Test (RSAT)

Treatment

1. Antibiotics – Doxycycline 100mg twice daily – 5-7 days .
2. Once daily Azithromycin may be given for only 3 days due to its long half-life.
3. A 5-10 days course of cephalosporin may be prescribed Five day administration of Cefpodoxime and  Cefusoxime has also been successful in producing bacteriologic cures.
4. Anti-Inflammatory: IBUPROFEN
5. Pottassium permanganate gargles.
6. Soft, bland and warm diet.

Nutritional Therapy

• A liquid or soft diet.
• Cool beverages, warm liquids, and flavored frozen desserts such as popsicles are often soothing. occasionally, the throat is so sore that liquids cannot be taken in adequate amounts by mouth.
• In severe situations, intravenous (IV) Fluids may be needed.
• Otherwise, the patient is encouraged to drink as much fluid as possible (at least 2-3 liters per day).

Chronic Pharyngitis

1. Chronic pharyngitis is a persistent inflammation of the pharynx. Characterized by multiple, white elongated Keratinized epithelial outgrowths project from the surface of the tonsil, base of the tongue, or posterior pharyngeal wall.
2. It is common for Adults who work in dusty surroundings and suffer from chronic cold.
3. Habitually use tobacco, Alcohol.

Types of Chronic Pharyngitis

• Hypertrophic: Characterised by general thinking and congestion of the pharyngeal mucosa membrane.
• Atrophic: Probably a late stage of the first type (the membrane is thin, whitish, glistening, and at times wrinkled.
• Chronic Granular :(Clergyman’s Sore Throat), characterized by numerous swollen lymph follicles on the pharyngeal wall.

Diagnosis

1. Foreign body sensation.
2. The constant sense of irritation or fullness in the throat, mucus that collects in the throat and can be expelled by coughing, and difficulty swallowing.
3. A Sore throat is worse with swallowing in the absence of pharyngitis suggests the possibility of thyroiditis.

Treatment

• Reliving Symptoms:- Avoiding exposure to irritants, and correcting any Upper Respiratory Infection.
• Nasal congestion ay is relived by short-term use of nasal sprays or medications containing CEPHEDRINE SULFATE (KONDON’S NASAL) or phenylephrine hydro chloride (Neo-Synephrine).
• For allergy, one of the antihistamine decongestants, medications, such as pseudoephedrine (sudalfed) or bromphenaramine/ pseudoephordrine, is prescribed orally every 4-6 hours.
• Aspirin or Acetamirophen is recommended for its Anti-Inflammatory and Analgesic Properties.
• For Adults with chronic Pharyngitis, tonsillectomy- is an effective option.

Conceptual Question

Question 1: What are most cases of pharyngitis caused by?

Answer:

 It is usually caused by viral and/or bacterial infections, such as the common cold and flu (both viral infections), or by infection with the Streptococcus bacterium (strep throat). Pharyngitis can also occur with mononucleosis (aka “mono”), a viral infection.

Question 2: What are the risk factors for pharyngitis?

Answer:

Common risk factors for pharyngitis include:

• History of ill contact.
• Overcrowding.
• Frequent sinus infections.
• Smoking.
• Attending daycare.
• Immunocompromised.
• Cold season.
• Allergic rhinitis.

Question 3: What are the most common and most important bacteria responsible for pharyngitis?

Answer:

The most common and important bacterial cause of pharyngitis is Streptococcus pyogenes (group A Streptococcus [GAS]).

Question 4: What test is used for pharyngitis?

Answer:

Cough, coryza, and diarrhea are more common with viral pharyngitis. Available diagnostic tests include throat culture and rapid antigen detection testing. Throat culture is considered the diagnostic standard, although the sensitivity and specificity of rapid antigen detection testing have improved significantly.

Question 5: What are the types of pharyngitis?

Answer:

There are two main types of pharyngitis—infectious and noninfectious. Infectious pharyngitis is throat inflammation caused by something that’s contagious, such as a virus or bacteria (germs).

Question 6: How can you prevent pharyngitis?

Answer:

Pharyngitis prevention:

1. avoid sharing food, drinks, and eating utensils.
2. avoid individuals who are sick.
3. wash your hands often, especially before eating and after coughing or sneezing.
4. use alcohol-based hand sanitizers when soap and water aren’t available.
5. avoid smoking and inhaling secondhand smoke.
   

7. Can pharyngitis be viral?

Answer:

Pharyngitis may occur as part of a viral infection that also involves other organs, such as the lungs or bowel. Most sore throats are caused by viruses.