Acute Pharyngitis

How does acute pharyngitis present clinically?

Sore throat, pain or swallowing or with phonation. Other symptoms based on the etiology. Viral pharyngitis is often associated with cough, hoarseness, coryza, conjunctivitis, diarrhea.

How is acute pharyngitis managed?

Symptomatic mainstay of treatment - fluids, warm saline gargles, topical anesthetics, lozenges, NSAIDs.

How is acute pharyngitis diagnosed?

Usually clinical. Rapid strep or throat culture may be performed to rule out bacterial cause if suspected.

How does streptococcal pharyngitis (strep throat) present clinically?

Dysphagia (pain on swallowing), fever. Not usually associated with symptoms of viral infections (e.g. cough, hoarseness, coryza, conjunctivitis, diarrhea).

What is streptococcal pharyngitis (strep throat)?

Group A Streptococcus (Streptococcus pyogenes). Rare in children <3 years of age. Highest incidence of rheumatic fever if untreated in children 5-15 years of age.

How is streptococcal pharyngitis (strep throat) managed?

Penicillin: first-line treatment (e.g. penicillin G or VK, amoxicillin). Penicillin allergy: macrolides, clindamycin, cephalosporins.

What are physical examination findings in streptococcal pharyngitis (strep throat)?

Pharyngeal edema or exudate, tonsillar exudate and/or petechiae. Anterior cervical lymphadenopathy.

How is streptococcal pharyngitis (strep throat) diagnosed?

Rapid antigen detection test: best initial test. -95% specific but only 55-90% sensitive -Most useful if positive, but if negative, throat cultures should be obtained, especially in children 5-15 years of age. Throat culture: definitive diagnosis (gold standard).

What are complications of streptococcal pharyngitis (strep throat)?

Rheumatic fever (preventable with antibiotics). Acute glomerulonephritis (not preventable with antibiotics). Peritonsillar abscess.

What is the etiology of acute pharyngitis?

Viral is the most common overall cause of pharyngitis. -Adenovirus, rhinovirus, enterovirus, Epstein-Barr virus, respiratory syncytial virus, influenza A and B, herpes zoster virus. Bacterial: Group A Streptococcus (S. pyogenes) most common bacterial cause.