Pharyngitis

Definition

Pharyngitis is an inflammation of the pharynx. It frequently results in a sore throat. Pharyngitis may be caused by a variety of microorganisms.

Causes, incidence, and risk factors

Pharyngitis is caused by a variety of microorganisms. Most cases are caused by a virus, including the the common cold virus, flu (influenza) virus, adenovirus, mononucleosis, HIV, and various others.

Bacterial causes of pharyngitis include Group A streptococcus, which causes " strep throat" in about 15% of cases. In addition, other but less common bacteria found in sore throats include Corynebacterium, Arcanobacterium, Neisseria gonorrhoeae, Chlamydia pneumoniae, and others. In up to 30% of cases, no organism is identified.

Most cases of pharyngitis occur during the colder months -- during respiratory disease season. It often spreads among family members.

Strep throat is a serious cause of pharyngitis. The complications of strep throat can include acute rheumatic fever, kidney dysfunction, and severe diseases such as bacteremia and streptococcal toxic shock syndrome.

Symptoms

• Sore throat
• Strep throat may be accompanied by fever, headache, and swollen lymph nodes in the neck
• Viral pharyngitis may be associated with runny nose and postnasal drip
• Severe cases may be accompanied by difficulty swallowing and, rarely, difficulty breathing
• Additional symptoms are dependent on the microorganisms causing the infection

Signs and tests

The health care provider will perform an examination of the pharynx to look for drainage or coating. The skin, eyes, and neck lymph nodes may be examined.

If there is suspicion for strep throat a streptococcal screen and/or throat swab culture may be performed. Additional throat cultures or blood tests may be done depending on the suspected organism (e.g., mononucleosis, gonorrhoeae).

Treatment

The treatment depends on the underlying cause. Viral infections are managed with warm salt water gargles, pain relievers, and fluids. Antibiotics are needed if strep throat is diagnosed.

Expectations (prognosis)

Most cases of pharyngitis go away on their own, without complications.

Complications

• The possible complications of strep throat include rheumatic fever, kidney inflammation, chorea, bacteremia (bloodstream infection) and, rarely, streptococcal toxic shock syndrome.
• In some severe forms of pharyngitis (e.g., severe mononucleosis pharyngitis) the airway may become blocked.
• Abscess around the tonsils or behind the pharynx are possible.

Calling your health care provider

Notify your provider if you develop a persistent sore throat that does not disappear in several days, or if you have high fevers, swollen lymph nodes in the neck, or a rash. If you have a sore throat and develop difficulty breathing, you must seek medical care immediately.

References