Pharyngitis

Pharyngitis

Article
Allergy
Ear, Nose, & Throat (ENT)
+2
Contributed byKrish Tangella MD, MBADec 17, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Pharyngitis (caused by Streptococcus)
  • Sore Throat (Pharyngitis)
  • Throat Infection (Pharyngitis)

What is Pharyngitis? (Definition/Background Information)

  • Pharyngitis is inflammation of the pharynx resulting in pain. The pharynx is located at the back of the throat (area above the Adam’s apple), below the tonsils
  • The inflammation may occur due to a viral or bacterial infection of the throat. Pharyngitis occurs more often in individuals with weak immune systems
  • The signs and symptoms of Pharyngitis may include soreness of the throat or irritation of the throat, which worsens when swallowing food and liquids. The inflammation may also spread to the tonsils
  • Severe cases of Pharyngitis can cause complications that include infections affecting the ear and sinus and severe persistent cough. The condition can be easily detected by a healthcare provider
  • Pharyngitis caused by viral infections, normally heal on its own in about a week’s time; while bacterial infections may need the administration of antibiotics
  • In general, Pharyngitis is not a life-threatening condition. It can be treated with medication and/or with simple home remedies. The prognosis of the condition is generally excellent

Who gets Pharyngitis? (Age and Sex Distribution)

  • Pharyngitis is a common condition that can affect individuals of all age groups. It is seen more often in children, 10-17 years old
  • Both males and females are affected
  • All racial and ethnic groups are affected and no particular preference is seen

What are the Risk Factors of Pharyngitis? (Predisposing Factors)

Risk factors associated with Pharyngitis may include:

  • Frequent infections of the sinuses
  • Having a weakened immune system
  • Allergies causing sinus symptoms
  • Smoking or being around smokers frequently; inhaling secondhand smoke
  • Cold and flu seasons
  • Working and living in small crowded areas, which makes it easier for infections to spread
  • Kids are more likely to get Pharyngitis. Therefore, being around large groups of children potentially places one at a higher risk for Pharyngitis

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Pharyngitis? (Etiology)

Pharyngitis may be caused by a variety of factors. However, it is usually the result of a viral infection (in 3 out of 4 cases). Sometimes, it may be caused by a bacterial infection (generally 1 in 4 cases).

  • Viruses that cause Pharyngitis include:
  • Rhinovirus that causes the common cold
  • Multiple types of influenza virus that causes the flu
  • Epstein-Barr virus (EBV), which causes mononucleosis or mono

There are other virus types that can cause infection affecting the pharynx, but the 3 above-mentioned types are the most common ones causing Pharyngitis.

  • Bacteria that cause Pharyngitis include:
  • Type/Group A Streptococcus, which causes Strep Throat Pharyngitis
  • Less common bacteria causing Pharyngitis include Gonorrhea and Chlamydia 

The bacterial or viral infection can be contagious and will spread from one infected individual to another.

Other non-infectious causes of Pharyngitis may include:

  • Allergies of the nose and throat
  • Stomach acid reflux disorder: The stomach acid is corrosive and can cause inflammation in the throat, due to frequent belching
  • Tumors or growths in the throat can cause soreness
  • Excessive coughing, which leads to muscle strain and inflammation

What are the Signs and Symptoms of Pharyngitis?

The signs and symptoms of Pharyngitis vary based on the cause of the condition. The cause of the condition may be viral, bacterial, or due to other factors.

Signs and symptoms of Viral Pharyngitis caused by Rhinovirus may include:

  • Soreness of the throat
  • Sneezing and cough
  • Fever lesser than 102 deg. F (or 38 deg. C)
  • Headaches

Signs and symptoms of Viral Pharyngitis caused by flu virus may include:

  • Fatigue, body aches, and chills
  • Fever greater than 102 deg. F (or 38 deg. C)
  • Throat soreness

Signs and symptoms of Viral Pharyngitis caused by Epstein-Barr virus may include:

  • Headaches
  • Throat soreness
  • Enlarged tonsils
  • Enlarged lymph nodes in the neck and armpit region
  • Swollen spleen and liver
  • Loss of appetite

 Signs and symptoms of Bacterial Pharyngitis (strep throat) may include:

  • Throat pain with sudden onset
  • Swollen tonsils that are red with white spots; red spots in the throat
  • Enlarged lymph nodes on the neck
  • Fever, nausea, and body aches

If Pharyngitis is associated with other conditions, it can occur as one of the symptoms of the underlying disease.

How is Pharyngitis Diagnosed?

A diagnosis of Pharyngitis involves a routine physical examination and a study of the individual’s medical history.

  • The physical examination may involve:
  • Examination of the individual’s breathing
  • Examination of the individual’s ears, throat, and nose (using a light source)
  • The healthcare provider will feel the individual’s neck and armpits for any swollen lymph nodes
  • A throat swab to check for bacteria or viruses: The saliva on the swab is tested for Group A streptococcus and common viruses (such as influenza virus). If the results for both streptococcus and flu virus are negative, the infection is generally assumed to be due to a viral cause

After the initial consultation, the healthcare provider may order further tests to diagnose Pharyngitis, if necessary.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Pharyngitis?

Severe cases of Pharyngitis that is caused by a viral/bacterial infection or other underlying conditions may result in complications that include:

  • Ear and sinus infections
  • Severe cough
  • Severe fever causing body aches
  • Glomerulonephritis or kidney inflammation, especially noted with streptococcus infection

How is Pharyngitis Treated?

The treatments will vary and are based on the cause of Pharyngitis (whether bacterial, viral, or due to other factors).

The treatment for bacterial (strep throat) Pharyngitis may include:

  • Antibiotics is the primary and most effective treatment for bacterial infection causing Pharyngitis
  • To help with the other symptoms of Bacterial Pharyngitis, a healthcare provider may suggest over-the-counter drugs to lower fever and relieve cough

Infection due to Viral Pharyngitis will get better on its own after some time. However, to help speed up the process, the following measures may be considered:

  • Drink plenty of fluids
  • Gargle with warm salt water
  • Avoid drinking alcohol
  • Take cough drops to soothe the throat
  • Drinking soup and other warm drinks, such as tea, can relieve some of the sore throat

How can Pharyngitis be Prevented?

The best way to prevent a bacterial or viral infection causing Pharyngitis is to practice clean and healthy habits that may include:

  • Washing hands properly after using the restroom, after sneezing or coughing, before eating, and after being in public spaces
  • Using correct coughing and sneezing technique, such as coughing or sneezing into a tissue and disposing it, or into the inner side of the upper arm
  • Do not share food or drinks with infected individuals
  • Regularly clean the sleeping and living areas of the house
  • Take adequate treatment for chronic sinusitis
  • Take proper control of allergies
  • Individuals with poor immunity should take precautions, especially when they are around large groups of children, since they are more likely to contract Pharyngitis

Also consider making certain lifestyle changes that include:

  • Avoid smoking or secondhand smoke
  • Use a humidifier to keep air in living spaces from getting too dry

What is the Prognosis of Pharyngitis? (Outcomes/Resolutions)

  • The prognosis for each Pharyngitis type is different. However, most types (bacterial or viral) are cured within a week or 15 days of contracting the infection, when adequate treatment is provided
    • The prognosis of Viral Pharyngitis is excellent, because it is generally self-limiting and should get better within 2 weeks
    • Bacterial Pharyngitis also has a good prognosis, if treated with the appropriate medications/antibiotics
  • If the soreness persists beyond 2 weeks, then it may indicate a more severe condition

Additional and Relevant Useful Information for Pharyngitis:

  • It is important to determine if the Pharyngitis is caused by a bacterial or viral infection, because it determines how a medical professional will treat the condition and how easily the infection can spread from one individual to another
  • A severe sore throat should always be examined by a healthcare provider because the possible complications may be severe when left untreated
  • Type A streptococcus is found in about 25% of the cases that present symptoms of Pharyngitis, while the other 75% is generally a viral infection
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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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