Pharyngitis
In medicine, pharyngitis is an upper respiratory tract infection that is "inflammation of the throat (pharynx)."[1]
Causes
Viral
The majority of pharyngtis is caused by viral infection.
Bacterial
Group A β-hemolytic streptococcus (streptococcus pyogenes).
Fusobacterium necrophorum may be as common as group A β-hemolytic streptococcus and can cause Lemierre syndrome.[2] Lemierre syndrome is "suppurative thrombophlebitis of the internal jugular vein, bacteremia, and metastatic infections."</ref>
Chemical and physical agents
- Aspiration burns [r]: Add brief definition or description
- Inhalation burns [r]: Add brief definition or description
- Swallowed caustics [r]: Add brief definition or description
- Bulimia [r]: Add brief definition or description
Diagnosis
Diagnosis has been reviewed by the Rational Clinical Examination who noted the Centor criteria.[3]
Centor criteria:[4]
- fever
- No cough
- Tonsilar exudate
- Tender anterior cervical lymph nodes
The McIsaac criteria adds to the Centor:[4]
- Age less than 15: add one point
- Age greater than 45: subtract one point
According to the Centers for Disease Control and Prevention:
- 0 points: do not test nor treat
- 1 points: do not test nor treat
- 2 points: rapid test and treat if positive
- 3 points
- Option 1: rapid test and treat if positive
- Option 2: treat empirically
- 4 points: treat empirically
Differential diagnosis
- Angioedema [r]: Allergic skin reaction causing localized redness, swelling, and itching. [e]
Pharyngitis caused by Fusobacterium necrophorum may lead to Lemierre syndrome.[2]
Treatment
Antibiotics may be used for patients with sufficient likelihood of streptococcal infection.[5]
Losenges with amylmetacresol and 2,4-dichlorobenzyl alcohol may help.[6]
Corticosteroids, such as prednisone 60 mg by mouth for one or two days may reduce symptoms among patients with severe pharyngitis.[7][8]
References
- ↑ Anonymous (2024), Pharyngitis (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 2.0 2.1 Centor, Robert (2009-12-01). "Expand the Pharyngitis Paradigm for Adolescents and Young Adults". Annals of Internal Medicine 151 (11): 812-815. PMID 19949147. Retrieved on 2009-12-01.
- ↑ Ebell MH, Smith MA, Barry HC, Ives K, Carey M (2000). "The rational clinical examination. Does this patient have strep throat?". JAMA 284 (22): 2912-8. PMID 11147989. [e]
- ↑ 4.0 4.1 Fine AM, Nizet V, Mandl KD (2012). "Large-Scale Validation of the Centor and McIsaac Scores to Predict Group A Streptococcal Pharyngitis.". Arch Intern Med. DOI:10.1001/archinternmed.2012.950. PMID 22566485. Research Blogging.
- ↑ McIsaac WJ, Kellner JD, Aufricht P, Vanjaka A, Low DE (2004). "Empirical validation of guidelines for the management of pharyngitis in children and adults.". JAMA 291 (13): 1587-95. DOI:10.1001/jama.291.13.1587. PMID 15069046. Research Blogging.
- ↑ McNally D, Simpson M, Morris C, Shephard A, Goulder M (2010). "Rapid relief of acute sore throat with AMC/DCBA throat lozenges: randomised controlled trial.". Int J Clin Pract 64 (2): 194-207. DOI:10.1111/j.1742-1241.2009.02230.x. PMID 19849767. Research Blogging.
- ↑ Hayward G, Thompson M, Heneghan C, Perera R, Del Mar C, Glasziou P (2009). "Corticosteroids for pain relief in sore throat: systematic review and meta-analysis.". BMJ 339: b2976. PMID 19661138. PMC PMC2722696.
- ↑ Kiderman A, Yaphe J, Bregman J, Zemel T, Furst AL (March 2005). "Adjuvant prednisone therapy in pharyngitis: a randomised controlled trial from general practice". Br J Gen Pract 55 (512): 218–21. PMID 15808038. PMC 1463093. [e]