What is pharyngitis?

Causes and Symptoms

Sore throat
is the chief complaint of pharyngitis. The throat (pharynx) extends from the nasal passages above and behind the mouth to the esophagus in the neck. Viruses or bacteria infect the pharynx and cause it to swell. The throat often appears red, swollen, or puffy and may have white spots of pus. Fever and cough are also common, and examination may reveal swollen tonsils. Throat scratchiness, pain when swallowing, enlarged lymph nodes in the neck, cough, and irritation are also common in pharyngitis.

Bacteria and viruses that cause pharyngitis generally enter the body through the nose or mouth. The organisms are transmitted through direct contact with someone who has one of these infections and are passed in nasal secretions and saliva.

Viruses that cause the common cold (coronavirus and rhinovirus) or other respiratory diseases may also produce symptoms of pharyngitis. Additionally, sinusitis
and postnasal drip may cause irritation of the pharynx. Pharyngitis associated with fever and the appearance of pus on the tonsils may indicate streptococcal pharyngitis, which can be diagnosed by a “quick antigen” test and confirmed by a culture. Persistent pharyngitis accompanied by malaise unresponsive to antibiotics may indicate mononucleosis
or other nonbacterial causes such as seasonal allergies, the inhalation of pollutants such as household cleaners or automobile exhaust, and smoking or exposure to secondhand smoke.

Treatment and Therapy

Viral pharyngitis is treated with aspirin or over-the-counter pain remedies and warm saltwater gargles. Bacterial pharyngitis is treated with a course of antibiotics either orally or by injection. Proper nutrition is important. Zinc boosts the immune system and relieves soreness. Vitamin C strengthens the immune system and the mucous membranes, and beta carotene restores the integrity of mucous membranes and supports immune function. If the tonsils have been chronically infected, they may require surgical removal (tonsillectomy).

Perspective and Prospects

Approximately 40 to 60 percent of cases of pharyngitis are caused by a virus, and about 15 percent are associated with streptococcal bacteria. In the United States, children average five sore throats per year and strep infection every four years. The incidence of pharyngitis and strep is highest in children between the ages of five and eighteen. Pharyngitis is rare in children below three years of age. Adults experience an average of two sore throats per year and strep infection approximately every eight years. Worldwide, the incidence is higher.

Formerly, it was commonly regarded as therapeutic to remove tonsils surgically to prevent repeated cases of pharyngitis, especially in children. Modern medical opinion on the subject, however, indicates that removing tonsils has not resulted in fewer cases of pharyngitis; therefore, tonsillectomy
surgery is performed less frequently than in the past.

Bibliography

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Morrison, Roger. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany, Calif.: Hahnemann Clinic, 1993.

Parker, Philip M. and James N. Parker.Pharyngitis: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References. San Diego, Calif.: ICON Health Publications, 2004.

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