Pharyngitis (Tonsillitis )

Causes

There are many causes of infections in the throat. The following are the most common infectious agents:

• viruses:
  
  • adenovirus
  • influenza virus
  • Epstein-Barr virus
  • herpes simplex virus
    
• bacteria:
  
  • group A ß - hemolytic streptococci (GABHS)
  • Neisseria gonorrhea
  • Haemophilus influenzae Type B
  • mycoplasma
    
• fungal infections
• parasitic infections
• cigarette smoke

Signs and symptoms

The symptoms of pharyngitis may include the following:

• Sore throat
• Pain when swallowing
• Fever
• Enlarged lymph nodes in your neck
• Runny nose and postnasal drip
• Headache
• In rare cases, difficulty breathing

Diagnosis

Physical examination of the pharynx reveals generalized redness and inflammation of the posterior wall and red, edematous mucous membranes studded with white or yellow follicles. Exudate is usually confined to the lymphoid areas of the throat, sparing the tonsillar pillars. Bacterial pharyngitis usually produces a large amount of exudate.

A throat culture may be performed to identify bacterial organisms that may be the cause of the inflammation.

Treatment

The focus for treatment of acute and chronic pharyngitis varies.

Acute pharyngitis

In acute viral pharyngitis, treatment is usually symptomatic, and consists mainly of rest, warm saline gargles, throat lozenges containing a mild anesthetic, plenty of fluids, and analgesics as needed. If the patient can't swallow fluids, hospitalization may be required for I.V. hydration.

Suspected bacterial pharyngitis requires rigorous treatment with penicillin or another broad-spectrum antibiotic because Streptococcus is the chief infecting organism. Antibiotic therapy should continue for 48 hours until culture results are back.

Chronic pharyngitis

In chronic pharyngitis, treatment requires the same supportive measures as acute pharyngitis but with greater emphasis on eliminating the underlying cause, such as an allergen. Preventive measures include adequate humidification and avoiding excessive exposure to air conditioning. In addition, the patient should be urged to stop smoking.

Prevention

• Avoid kissing or sharing cups and eating utensils with anyone who has pharyngitis, a cold, flu, mononucleosis, or bacterial infection.
• Avoid any irritants that might affect your throat, such as smoke from cigarettes, cigars, or pipes.