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Throat anatomy
Throat anatomy

Pharyngitis
Definition:
An inflammation of the pharynx which frequently results in a sore throat and may be caused by a variety of microorganisms.

Causes, incidence, and risk factors:

Pharyngitis is caused by a variety of microorganisms. Most cases are viral and include the virus causing the common cold, flu (influenza virus), adenovirus, mononucleosis, HIV among various others. Bacterial causes include Group A streptococcus which causes strep throat (15% of cases), in addition to Corynebacterium, Arcanobacterium,Neisseria gonorrhoeae,Chlamydia pneumoniae and others. In up to 30% of cases, no organism is identified.

Most cases of pharyngitis occur during the colder months -- during respiratory disease season. Spread among household members is common. The medical importance of recognizing strep throat as a cause of pharyngitis stems from the need to prevent its complications which can include acute rheumatic fever, kidney dysfunction and severe disease such as bacteremia and rarely streptococcal toxic shock syndrome.
Symptoms:
  • sore throat
  • additional symptoms are dependent on the underlying microorganisms
  • step throat may be accompanied by fever, headache, swollen lymph nodes in the neck
  • viral pharyngitis may be associated with runny nose (rhinorrhea) and postnasal discharge
  • severe cases of pharyngitis may be accompanied by difficulty swallowing and rarely difficulty breathing
Signs and tests:
  • A physical exam with attention to the pharynx to assess whether drainage/coating (exudates) are present, as well as skin, eyes, neck lymph nodes is frequently done.
  • If there is suspicion for strep throat a streptococcal screen and/or throat swab culture may be performed. Additional throat cultures and/or blood tests may be done depending on the suspected organism (e.g., mononucleosis, gonorrheae, etc).
Treatment:
Treatment is dependent upon the underlying cause of pharyngitis. Viral infections are managed with supportive measures such as warm saline gargles, analgesics and fluids. Antibiotic therapy is indicated if strep throat is diagnosed.
Expectations (prognosis):
Most cases of pharyngitis are self-limited and resolve without sequelae.
Complications:
  • complications of strep throat: rheumatic fever, glomerulonephritis (kidney inflammation), chorea, bacteremia (bloodstream infection) and rarely streptococcal shock syndrome
  • in some severe forms of pharyngitis (e.g., severe mononucleosis-pharyngitis) airway obstruction may occur
  • peritonsillar abscess, retropharyngeal abscess
Calling your health care provider:
Notify your provider if you develop a persistent sore throat that does not resolve in several days or if you have high fevers, swollen lymph nodes in the neck or rash. If you have a sore throat and develop difficulty breathing, you must seek medical care immediately.
Review Date: 9/1/2001
Reviewed By: Rocio Hurtado, M.D., Infectious Diseases Division, Massachusetts General Hospital and Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.
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