Pharyngitis – Types, Causes, Risk Factors and Treatment

Definition

Pharyngitis is an inflammation of the throat (also known as the pharynx) often caused by a bacterial or viral infection. The main symptom is a sore throat; other symptoms may include fever, cough, congestion, body aches, and swollen lymph nodes in the neck. These symptoms can range from mild to severe. While many germs can cause pharyngitis, including bacteria (such as group A Streptococcus, which causes strep throat) and many types of viruses, pharyngitis can also result from allergies, voice strain, and gastric reflux, a condition in which stomach acids flow up into the throat.

Most episodes of pharyngitis resolve with treatment, and some minor inflammations even go away on their own. However, left untreated, the infection can enter the bloodstream and cause sepsis, which is a life-threatening condition.

Epidemiology

The 2000 National Ambulatory Medical Care Survey found that acute pharyngitis accounts for 1.1 percent of visits in the primary care setting and is ranked in the top 20 reported primary diagnoses resulting in office visits. Peak seasons for sore throat include late winter and early spring. Transmission of typical viral and GABHS pharyngitis occurs mostly by hand contact with nasal discharge, rather than by oral contact. Symptoms develop after a short incubation period of 24 to 72 hours.

Types of Pharyngitis

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).

Noninfectious pharyngitis is throat swelling stemming from things you can’t catch, for example, environmental influences like cigarette smoke or a digestive disorder that allows irritating stomach acid to flow back up into the throat.

Pharyngitis risk factors

Risk factors for pharyngitis include:

  • Cold and flu seasons
  • Having close contact with someone who has a sore throat or cold
  • Smoking or exposure to secondhand smoke
  • Frequent sinus infections
  • Allergies
  • Attending daycare or crowded schools

Causes of Pharyngitis

Pharyngitis is most frequently caused by the common cold or flu. It often occurs seasonally during the colder months, and frequently spreads among family members. Pharyngitis may also be caused by any of the following conditions:

  • Strep throat
  • Oral candidiasis (oral thrush)
  • Infectious mononucleosis
  • Coxsackie virus
  • Herpes simplex virus, or cold sores
  • Tonsillar abscess
  • Allergic reaction
  • Insect or spider bite

Rarely, pharyngitis may be caused by other bacteria, such as those that cause gonorrhea or chlamydia. In the case of the latter, the bacteria causing the sore throat is not necessarily been sexually transmitted.

Symptoms

Symptoms of a pharyngitis or sore throat can vary depending on the cause. Signs and symptoms might include:

  • Pain or a scratchy sensation in the throat
  • Pain that worsens with swallowing or talking
  • Difficulty swallowing
  • Sore, swollen glands in your neck or jaw
  • Swollen, red tonsils
  • White patches or pus on your tonsils
  • A hoarse or muffled voice

Infections causing a sore throat might result in other signs and symptoms, including:

  • Fever
  • Cough
  • Runny nose
  • Sneezing
  • Body aches
  • Headache
  • Nausea or vomiting

Complications

Nonsuppurative complication

  • Acute rheumatic fever (ARF)
  • Acute glomerulonephritis
  • Scarlet Fever
  • Poststreptococcal arthritis (PSRA)
  • Streptoccal toxic shock syndrome

Suppurative complications

  • Peritonsillar abscess
  • Mastoiditis
  • Otitis Media
  • Sinusitis
  • Necrotizing fascitis
  • Strptococcal bacteremia
  • Meningitis

Diagnosis and test

Physical exam

If you’re experiencing symptoms of pharyngitis, your doctor will look at your throat. They’ll check for any white or gray patches, swelling, and redness. Your doctor may also look in your ears and nose. To check for swollen lymph nodes, they will feel the sides of your neck.

Throat culture

If your doctor suspects that you have strep throat, they will likely take a throat culture. This involves using a cotton swab to take a sample of the secretions from your throat. Most doctors are able to do a rapid strep test in the office. This test will tell your doctor within a few minutes if the test is positive for streptococcus. In some cases, the swab is sent to a lab for further testing and results are not available for at least 24 hours.

Blood tests

If your doctor suspects another cause of your pharyngitis, they may order blood work. A small sample of blood from your arm or hand is drawn and then sent to a lab for testing. This test can determine whether you have mononucleosis. A complete blood count (CBC) test may be done to determine if you have another type of infection.

Treatment and medications

Most sore throats are caused by viruses. Antibiotics do not help viral sore throats. Using these medicines when they are not needed leads to antibiotics not working as well when they are needed.

Sore throat is treated with antibiotics if:

  • A strep test or culture is positive. Your provider cannot diagnose strep throat by symptoms or a physical exam alone
  • A culture for chlamydia or gonorrhea is positive

Sore throat caused by the flu (influenza) may be helped by antiviral medicines.

The following tips may help your sore throat feel better:

  • Drink soothing liquids. You can either drink warm liquids, such as lemon tea with honey, or cold liquids, such as ice water. You could also suck on a fruit-flavored ice pop
  • Gargle several times a day with warm salt water (1/2 tsp or 3 grams of salt in 1 cup or 240 milliliters of water)
  • Suck on hard candies or throat lozenges. Young children should not be given these products because they can choke on them
  • Use of a cool-mist vaporizer or humidifier can moisten the air and soothe a dry and painful throat
  • Try over-the-counter pain medicines, such as acetaminophen

Home remedies for pharyngitis

There are a number of ways to help manage the symptoms of the condition:

  • Drinking plenty of fluids is key to avoiding dehydration, which can make the symptoms of pharyngitis worse.
  • Taking over the counter painkillers, such as ibuprofen or paracetamol, is a good way of managing pain, headaches and fever. These medicines should be taken according to the instructions on the packet.
  • Lozenges can be useful in easing pain.
  • Other over-the-counter products, such as anesthetic sprays, which can be bought from pharmacies and stores, can also help alleviate certain symptoms.

Pharyngitis prevention

While it’s impossible to prevent all infections, you can help to decrease exposure and spreading:

  • Wash your hands frequently, especially after blowing your nose or after caring for a child with a sore throat.
  • If someone in your home has pharyngitis, keep his or her eating utensils and drinking glasses separate from those of other family members. Wash these objects thoroughly in hot, soapy water.
  • If a toddler with pharyngitis has been chewing or sucking on toys, wash these objects thoroughly in water and disinfectant soap, then rinse well.
  • Promptly dispose of any dirty tissues from runny noses and sneezes, and then wash your hands.
  • Do not allow a child who has been diagnosed with strep throat to return to school or day care until he or she has been taking antibiotics for at least 24 hours and symptoms have improved.

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