Pharyngitis

Definition

Pharyngitis - often simply referred to as a sore throat - is inflammation of the pharynx, the portion of the throat that lies just beyond the back of the roof of the mouth and stretches to the Adam's apple (pharynx). It usually occurs when viruses (or sometimes bacteria) from a cold, flu, or sinus infection involve the throat.

Description

Pharyngitis is very common but rarely serious. Most cases clear up on their own after three to ten days and require no therapy other than pain relievers to ease the discomfort. Rarely, though, tissues may swell considerably and obstruct breathing - a life-threatening condition.

In addition, strep throat (caused by streptococcal bacteria) requires antibiotics to prevent complications, including rheumatic fever, a condition that can permanently damage the heart valves.

Diphtheria is a rare but serious bacterial variety of pharyngitis.

Pharyngitis appears in three forms - nonexudative, exudative, and ulcerative:

Nonexudative - although group A streptococci may cause nonexudative pharyngitis, viruses are by far the most common causative agents of this group.

Exudative - group A streptococcus is the most common bacterial cause of exudative and nonexudative pharyngitis. Beta-hemolytic streptococci in groups C and G have also been associated with exudative pharyngitis and tonsillitis.

Ulcerative - coxsackievirus A and herpes virus are the most common cause of ulcerative pharyngitis. Vincent's angina due to fusobacteria and poor oral hygiene may also cause ulcerative pharyngitis that is associated with malaise and low-grade fever. The most common finding is a unilateral tonsillar ulceration with a gray necrotic membrane.

Symptoms

The most common symptoms are:

• Sore or red, raw throat

• Difficulty speaking or swallowing

• Tender, swollen lymph nodes (glands) in the neck

• Fever

• Headache

• Earache

Treatment

Symptoms such as sore throat or fever can be treated with nonprescription pain relievers such as aspirin. Gargling with a half teaspoon of salt dissolved in a glass of warm water or using antiseptic lozenges or sprays may provide temporary relief.

Antibiotics are prescribed for pharyngitis caused by bacteria. These drugs are effective in killing bacteria, and certain other organisms, but not viruses.

If the diagnosis is strep throat, it is very important to continue the antibiotics for at least 10 to 14 days, even if sore throat and other symptoms subside, to assure that all the bacteria are eliminated. Strep infection can lead to rheumatic fever and damage to the heart valves.

Pharyngitis caused by viruses clears up on its own; antibiotics are not effective against viral infections, so treatment is aimed at easing symptoms. One should not smoke and alcohol intake should be curbed because smoke and alcohol irritate the throat.

Persistent pharyngitis caused by exposure to toxic fumes, air pollution, or industrial chemicals is treated by reducing or eliminating exposure to the noxious agents.

Questions to Ask Your Doctor

What type of pharyngitis is it?

Is it bacterial or viral?

Is it serious?

Will antibiotics help?

Is there a risk of rheumatic fever?

What can be done to alleviate the symptoms?