| ID | 299 |
|---|---|
| Name | ACUTE SIMPLE PHARYNGITIS |
| Cause | There are numerous viral and bacterial agents that can cause pharyngitis. They include: measles adenovirus, which is one of the causes of the common cold chickenpox croup, which is a childhood illness distinguished by a barking cough whooping cough group A streptococcus influenza, or mononucleosis. |
| Signs Symptoms | The incubation period is typically two to five days. Symptoms that accompany pharyngitis vary depending on the underlying condition. In addition to a sore, dry, or scratchy throat, a cold or flu may cause: sneezing runny nose headache cough fatigue body aches chills fever (a low-grade fever with a cold and higher-grade fever with the flu) In addition to a sore throat, the symptoms of mononucleosis include: swollen lymph nodes severe fatigue fever muscle aches general malaise loss of appetite rash Strep throat, another type of pharyngitis, can also cause: difficulty in swallowing red throat with white or gray patches swollen lymph nodes fever chills loss of appetite nausea unusual taste in the mouth general malaise The length of the contagious period will also depend on your underlying condition. If you have a viral infection, you will be contagious until your fever runs its course. If you have strep throat, you may be contagious from the onset until you’ve spent 24 hours on antibiotics. The common cold usually lasts less than 10 days. Symptoms, including fever, may peak around three to five days. If pharyngitis is associated with a cold virus, you can expect your symptoms to last this duration of time. |
| Diagnosis | The diagnosis of acute pharyngitis is based on the patient's medical history and examination. The more or less sudden presentation of the picture and its clinical characteristics (fever, general malaise, bad breath, cervical pain, etc.) make suspect a picture of acute pharyngo-tonsillitis. Diagnostic investigations culture of throat swab for group A Streptococcus (GAS) culture of throat swab for gonococcus or chlamydia. serum monospot for Epstein-Barr virus infection. |
| Investigations | Diagnostic investigations culture of throat swab for group A Streptococcus (GAS) culture of throat swab for gonococcus or chlamydia. serum monospot for Epstein-Barr virus infection. |
| Management | Management: 1. Mild cases: Warm water gurgling, plenty of fluids. Alkaline gargle (sodibicarb in warm water) is soothing. 2. Severe cases: Broad-spectrum antibiotic like amoxicillin, cephalosporin, erythromycin etc. should be given. Aspirin 300mg or paracetamol 500mg 1 tablet 3 times daily may be given for pain & temperature. |
| Introduction | Acute pharyngitis is an infection caused by viruses or bacteria. In many of these cases, there is a painful enlargement of the neck nodes (reactive lymphadenitis), since lymphoid tissue is also presen |
| History | |
| Etiology | Etiology: Cold, typhoid, measles. Predisposing factor: Dental sepsis, mouth breathing. |
| Clinical Features | Clinical f eatures: 1. Sore throat, slight rise of temperature, bodyache & headache. 2. Cough, difficulty in swallowing & slight hoarseness of voice. 3. On examination- pharyngeal mucosa is congested. Uvula is swollen & oedematous. Resolution usually occurs in 3-7 days. |
| Preventions | avoid sharing food, drinks, and eating utensils. avoid individuals who are sick. wash your hands often, especially before eating and after coughing or sneezing. use alcohol-based hand sanitizers when soap and water aren't available. avoid smoking and inhaling secondhand smoke. |
| Treatment | How is pharyngitis treated? The treatment depends on the cause. Viral pharyngitis goes away on its own with salt water gargles, pain relievers and extra fluids to help alleviate the symptoms. Bacterial pharyngitis is treated with antibiotics; and fungal pharyngitis, with antifungal medications. Symptomatic treatment (fever and pain): paracetamol or ibuprofen PO). Centor score ≤ 1: viral pharyngitis, which typically resolves within a few days (or weeks, for IM): no antibiotic treatment. Centor score ≥ 2 or scarlet fever: antibiotic treatment for GAS infections Antibiotics benzathine benzylpenicillin IM Children under 30 kg (or under 10 years): 600 000 IU single dose Children 30 kg and over (or 10 years and over) and adults: 1.2 MIU single dose Penicillin V is the oral reference treatment, but poor adherence is predictable due to the length of treatment. phenoxymethylpenicillin (penicillin V) PO for 10 days Children 1 to < 6 years: 250 mg 2 times daily Children 6 to < 12 years: 500 mg 2 times daily Children 12 years and over and adults: 1 g 2 times daily Children under 1 year: 125 mg 2 times daily Amoxicillin is an alternative and the treatment has the advantage of being relatively short. However, it can cause adverse skin reactions in patients with undiagnosed IM and thus should be avoided when IM has not been excluded amoxicillin PO for 6 days Children: 25 mg/kg 2 times daily Adults: 1 g 2 times daily Macrolides should be reserved for penicillin allergic patients as resistance to macrolides is frequent and their efficacy in the prevention of rheumatic fever has not been studied. azithromycin PO for 3 days Children: 20 mg/kg once daily (max. 500 mg daily) Adults: 500 mg once daily |
| Complications | Rarely, suppurative and nonsuppurative complications can occur after group A strep pharyngitis. Suppurative complications result from the spread of group A strep from the pharynx to adjacent structures. They can include: Peritonsillar abscess Retropharyngeal abscess Cervical lymphadenitis Mastoiditis Other focal infections or sepsis are even less common. Acute rheumatic fever is a nonsuppurative sequelae of group A strep pharyngitis. Post-streptococcal glomerulonephritis is a nonsuppurative sequelae of group A strep pharyngitis or skin infections. These complications occur after the original infection resolves and involve sites distant to the initial group A strep infection site. They are thought to be the result of the immune response and not of direct group A strep infection. |
| Prognosis | In general, the prognosis for pharyngitis is good as both viral and bacterial infections are typically self-limited to 5 to 7 days. In developing countries, over 20 million individuals are affected by group A streptococci and develop acute rheumatic fever. This disorder is the leading cause of death in young people |
| Types | It may be classified as acute or chronic. Acute pharyngitis may be catarrhal, purulent, or ulcerative, depending on the causative agent and the immune capacity of the affected individual. Chronic pharyngitis may be catarrhal, hypertrophic, or atrophic. Tonsillitis is a subtype of pharyngitis |
| Classification | It may be classified as acute or chronic. Acute pharyngitis may be catarrhal, purulent, or ulcerative, depending on the causative agent and the immune capacity of the affected individual. Chronic pharyngitis may be catarrhal, hypertrophic, or atrophic. Tonsillitis is a subtype of pharyngitis |
| Observation | |
| Pathology | Pharyngitis is the inflammation of the mucous membranes of the oropharynx. In most cases, it is caused by an infection, either bacterial or viral. Other less common causes of pharyngitis include allergies, trauma, cancer, reflux, and certain toxins |
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