Infections of the pharynx

Infections of the pharynx:


Acute Viral Pharyngitis
Etiology, symptoms: Acute viral pharyngitis, which is often caused by influenza or parainfluenza viruses, typically presents clinically with sudden onset of fever, sore throat, and headache. There may also be coughing and catarrhal symptoms (e.g., rhinitis, sinusitis).
Concomitant cervical adenopathy may also be present.

Diagnosis: The pharyngeal mucosa appears red and coated on mirror examination. If a bacterial etiology is suspected, a rapid streptococcal test can be performed

Treatment is supportive and consists mainly of analgesic agents. Cold compresses to the neck can also help to relieve pain. The patient should drink copious amounts of warm liquid to ease complaints

Chronic Pharyngitis
Etiology: Chronic pharyngitis is often a result of long term exposure to various noxious agents (nicotine, alcohol, chemicals, gaseous irritants). It can also occur as a result of chronic mouth breathing due to nasal airway obstruction (e.g., deviated septum) or as an accompanying feature of chronic sinusitis.

Symptoms: The main clinical manifestations are a dry throat sensation with frequent throat clearing and the drainage of a viscous mucus. Some patients have a dry cough and a foreign-body sensation in the pharynx.

Diagnosis: The history will often direct attention to possible noxious agents. On mirror examination, the pharyngeal mucosa appears red and “grainy” due to the hyperplasia of lymphatic tissue on the posterior pharyngeal wall (hypertrophic form: The pharyngeal mucosa may also have a smooth, shiny appearance in some cases (atrophic form). A thorough nasal examination should be performed to exclude nasal airway obstruction as the cause of chronic pharyngitis, giving particular attention to possible septal deviation or turbinate hyperplasia.

The middle meatus should also be examined endoscopically

Treatment: Any agents causing the pharyngitis should be avoided. Also, an herbal product such as sage or chamomile can be used in a steam inhalation to moisten the airways. In patients with nasal airway obstruction due to septal deviation or turbinate hyperplasia, a
surgical procedure can be performed to improve complaints

Tonsillitis
Tonsillitis, or infection of the tonsils is commonly seen in ENT and in general practice. Common bacterial pathogens are B haemolytic streptococcus, pneumococcus and homophiles influenza. Sometimes this occurs following an initial viral infection. Treatment consists of appropriate antibiotics (e.g. penicillin), regular simple analgesia, oral fluids and bed rest.