Pharyngitis

Epidemiology

  • Association of Pharyngitis with Acute Viral Rhinosinusitis/”Common Cold”: pharyngitis occurs most commonly as part of the common cold syndrome and is, therefore, is usually associated with the same viruses that cause the common cold

Etiology

Infection

Viral

  • Adenovirus (see xxxx, [[xxxx]]): pharyngitis is often a predominant complaint
  • Herpes Simplex Virus (HSV) (see Herpes Simplex Virus, [[Herpes Simplex Virus]])
    • Acute Vesiculo-Ulcerative Pharyngitis: may occur with primary HSV infection
    • Chronic Herpes Simplex Virus (HSV) Ulcerative Pharyngitis-Laryngotracheitis
    • Gingivostomatitis (with exudative character): may occur with primary HSV infection
  • Coronavirus (see Coronavirus, [[Coronavirus]])
  • Coxsackie Virus (see Coxsackie Virus, [[Coxsackie Virus]]): may present with vesicles and ulcers (herpangina)
  • Cytomegalovirus (CMV) (see Cytomegalovirus, [[Cytomegalovirus]])
    • Heterophil antibody-negative mononucleosis syndrome with acute or chronic non-exudative pharyngitis
    • Oral ulcerations: may occur in immunosuppressed patients
  • Epstein-Barr Virus (EBV) (see Epstein-Barr Virus, [[Epstein-Barr Virus]]): EBV mononucleosis typically presents with an acute exudative pahryngitis
  • Hemorrhagic Fever Viruses: pharyngitis may occur prior to development of skin lesions
    • Arenaviridae
      • Lassa Fever (Lassa Virus) (see Lassa Virus, [[Lassa Virus]])
      • Lujo Virus
      • Argentine Hemorrhagic Fever (Junin Virus)
      • Bolivian Hemorrhagic Fever (Machupo Virus)
      • Brazilian Hemorrhagic Fever (SabiĆ” Virus)
      • Venezuelan Hemorrhagic Fever (Guanarito Virus)
    • Bunyaviridae
      • Hantavirus Genus that cause hemorrhagic fever with renal syndrome (HFRS)
      • Crimean-Congo Hemorrhagic Fever (CCHF) virus (Nairovirus genus)
      • Garissa Virus and Ilesha Virus from the Orthobunyavirus
      • Rift Valley Fever Virus (Phlebovirus Genus)
    • Filoviridae
      • Ebola Virus (see xxxx, [[xxxx]])
      • Marburg Virus (see xxxx, [[xxxx]])
    • Flaviviridae
      • Dengue Fever (see xxxx, [[xxxx]])
      • Yellow Fever (see xxxx, [[xxxx]])
      • Omsk Hemorrhagic Fever Virus
      • Kyasanur Forest Disease Virus
    • Rhabdoviridae
      • Rhabdoviruses
  • Human Immunodeficiency Virus (HIV) (see Human Immunodeficiency Virus, [[Human Immunodeficiency Virus]]): pharyngitis may occur with primary HIV infection
  • Influenza (see Influenza Virus, [[Influenza Virus]]): pharyngitis is often a predominant complaint
  • Respiratory Syncytial Virus (RSV) (see Respiratory Syncytial Virus, [[Respiratory Syncytial Virus]])
  • Rhinovirus (see Rhinovirus, [[Rhinovirus]])

Bacterial

  • Corynebacterium Diphtheriae (see xxxx, [[xxxx]])
  • Streptococcus Pyogenes (Group A Streptococcus) (see Streptococcus Pyogenes, [[Streptococcus Pyogenes]])
  • Mixed Anaerobes: seen in Vincent’s angina and peritonsillar abscess
  • xxx
  • xxx

Fungal

  • Oropharyngeal Thrush/Candidiasis (see Candida, [[Candida]])
  • xxx
  • xxx
  • xxx

Drugs

  • Eculizumab (Soliris) (see Eculizumab, [[Eculizumab]])
  • Indacaterol (Arcapta) (see Indacaterol, [[Indacaterol]])
  • xxxxx
  • xxxxx
  • xxxxx
  • xxxxx
  • xxxxx

Other

  • Adult-Onset Still’s Disease (see Adult-Onset Still’s Disease, [[Adult-Onset Stills Disease]])
  • Periodic Fever + Aphthous Stomatitis + Pharyngitis + Adenitis (PFAPA) Syndrome: usually starts in young children
  • xxx
  • xxx
  • xxx
  • xxx

Physiology

  • Pain of Pharyngitis: mediated by kinins (which are potent stimulators of nerve endings)
    • Bradykinin: present in nasal secretions in the common cold
      • Experimental topical application of bradykinin induces a sore throat and nasal symptoms
    • Lysylbradykinin: present in nasal secretions in the common cold

Clinical Manifestations

Otolaryngologic Manifestations

  • Exudative Pharyngitis
    • Exudates are typically absent in cases due to rhinovirus, coronavirus, influenza virus, and respiratory syncytial virus (RSV)
    • Exudates may be present in cases due to Streptococcus Pyogenes, mixed anaerobic infection (Vincent’s angina, peritonsillar abscess), adenovirus, herpes simplex virus (HSV), epstein-barr virus (EBV), and Corynebacterium Diphtheriae

Other Manifestations

  • xxx

References

  • xxx