Not to be confused with laryngitis.
Inflamed oropharynx: swollen and red.
|Classification and external resources|
Like many types of inflammation, pharyngitis can be chronic or acute (quickly developing and temporary). Pharyngitis can result in very large tonsils, which cause trouble swallowing and breathing. Pharyngitis can be accompanied by a cough or fever, especially if caused by a systemic infection.
Most acute cases are caused by viral infections (40–80%), with the remainder caused by bacterial infections, fungal infections, or irritants such as pollutants or chemical substances. Treatment of viral causes is mainly symptomatic, but bacterial or fungal causes may be treated with antibiotics and anti-fungal medicines respectively.
The word comes from the Greek word pharynx meaning "throat" and the suffix -itis meaning "inflammation."
ClassificationPharyngitis is a type of inflammation, most commonly caused by an upper respiratory tract infection. It may be classified as acute or chronic. An acute pharyngitis may be catarrhal, purulent or ulcerative, depending on the virulence of the causative agent and the immune capacity of the affected individual. Chronic pharyngitis is the most common otolaringologic disease and may be catarrhal, hypertrophic or atrophic.
If the inflammation includes tonsillitis, it is called pharyngotonsillitis. Another sub classification is nasopharyngitis (the common cold).
CauseThe majority of cases are due to an infectious organism acquired from close contact with an infected individual.
- Adenovirus – the most common of the viral causes. Typically the degree of neck lymph node enlargement is modest and the throat often does not appear red, although it is very painful.
- Orthomyxoviridae which cause influenza – present with rapid onset high temperature, headache and generalized ache. A sore throat may be associated.
- Infectious mononucleosis ("glandular fever") caused by the Epstein–Barr virus. This may cause significant lymph gland swelling and an exudative tonsillitis with marked redness and swelling of the throat. The heterophile test can be used if this is suspected.
- Herpes simplex virus can cause multiple mouth ulcers.
- Common cold: rhinovirus, coronavirus, respiratory syncytial virus, parainfluenza virus can cause infection of the throat, ear, and lungs causing standard cold-like symptoms and often extreme pain.
- Streptococcal pharyngitis
- Fusobacterium necrophorum
Non-infectiousPharyngitis may also be caused by mechanical, chemical or thermal irritation, for example cold air or acid reflux. Some medications may produce pharyngitis such as pramipexole and antipsychotics.
|Points||Probability of Strep||Management|
|1 or less||<10%||No antibiotic or culture needed|
|2||11–17%||Antibiotic based on culture or RADT|
|4 or 5||52%||Empiric antibiotics|
The modified Centor criteria may be used to determine the management of people with pharyngitis. Based on 5 clinical criteria, it indicates the probability of a streptococcal infection.
One point is given for each of the criteria:
- Absence of a cough
- Swollen and tender cervical lymph nodes
- Temperature >38.0 °C (100.4 °F)
- Tonsillar exudate or swelling
- Age less than 15 (a point is subtracted if age >44)
- Age less than 15: add one point
- Age greater than 45: subtract one point
ManagementThe majority of time treatment is symptomatic. Specific treatments are effective for bacterial, fungal, and herpes simplex infections.
- Analgesics such as NSAIDs and acetaminophen can help reduce the pain associated with a sore throat. (Note: Aspirin may be used in adults but is not recommended in children due to the risk of Reye syndrome.
- Steroids (such as dexamethasone) have been found to be useful for severe pharyngitis.
- Viscous lidocaine relieves pain by numbing the mucus membranes.
- Antibiotics are useful if a bacterial infection is the cause of the sore throat. For viral infections, antibiotics have no effect.
- Oral analgesic solutions, the active ingredient usually being phenol, but also less commonly benzocaine, cetylpyridinium chloride and/or menthol. Chloraseptic and Cēpacol are two examples of brands of these kinds of analgesics.
AlternativeAlternative medicines are promoted and used for the treatment of sore throats. However, they are poorly supported by evidence.
EpidemiologyAcute pharyngitis is the most common cause of a sore throat and, together with cough, it is diagnosed in more than 1.9 million people a year in the United States.
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