Pharyngitis: Difference between revisions

From Citizendium
Jump to navigation Jump to search
imported>Howard C. Berkowitz
No edit summary
mNo edit summary
 
(11 intermediate revisions by 3 users not shown)
Line 1: Line 1:
{{subpages}}
{{subpages}}
{{TOC|right}}
{{TOC|right}}
In [[medicine]], '''pharyngitis''' is "inflammation of the throat (pharynx)."<ref>{{MeSH}}</ref>
In [[medicine]], '''pharyngitis''' is an upper [[respiratory tract infection]] that is "inflammation of the throat (pharynx)."<ref>{{MeSH}}</ref>


==Causes==
==Causes==
Line 7: Line 7:
The majority of pharyngtis is caused by viral infection.
The majority of pharyngtis is caused by viral infection.
===Bacterial===
===Bacterial===
===Chemical and physical agents==
Group A β-hemolytic streptococcus ([[streptococcus pyogenes]]).
 
''[[Fusobacterium necrophorum]]'' may be as common as group A β-hemolytic streptococcus and can cause [[Lemierre syndrome]].<ref name="pmid19949147">{{Cite journal | volume = 151 | issue = 11 | pages = 812-815 | last = Centor | first = Robert | title = Expand the Pharyngitis Paradigm for Adolescents and Young Adults | journal = Annals of Internal Medicine | accessdate = 2009-12-01 | date = 2009-12-01 | url = http://www.annals.org/content/151/11/812.abstract | pmid=19949147 }}</ref> Lemierre syndrome is "suppurative thrombophlebitis of the internal jugular vein, bacteremia, and metastatic infections."</ref>
 
===Chemical and physical agents===
{{r|Aspiration burns}}
{{r|Aspiration burns}}
{{r|Inhalation burns}}
{{r|Inhalation burns}}
{{r|Swallowed caustics}}
{{r|Swallowed caustics}}
{{r|Bulimia}}
{{r|Bulimia}}
==Differential diagnosis==
 
==Diagnosis==
Diagnosis has been reviewed by the [[Rational Clinical Examination]] who noted the Centor criteria.<ref name="pmid11147989">{{cite journal|  author=Ebell MH, Smith MA, Barry HC, Ives K, Carey M| title=The  rational clinical examination. Does this patient have strep throat? |  journal=JAMA | year= 2000 | volume= 284 | issue= 22 | pages= 2912-8 |  pmid=11147989 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11147989  }} </ref>
 
Centor criteria:<ref name="pmid22566485">{{cite journal| author=Fine AM, Nizet V, Mandl KD| title=Large-Scale Validation of the Centor and McIsaac Scores to Predict Group A Streptococcal Pharyngitis. | journal=Arch Intern Med | year= 2012 | volume=  | issue=  | pages=  | pmid=22566485 | doi=10.1001/archinternmed.2012.950 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22566485  }} </ref>
* [[fever]]
* No cough
* Tonsilar exudate
* Tender anterior cervical lymph nodes
 
The McIsaac criteria adds to the Centor:<ref name="pmid22566485">{{cite journal| author=Fine AM, Nizet V, Mandl KD| title=Large-Scale Validation of the Centor and McIsaac Scores to Predict Group A Streptococcal Pharyngitis. | journal=Arch Intern Med | year= 2012 | volume=  | issue=  | pages=  | pmid=22566485 | doi=10.1001/archinternmed.2012.950 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22566485  }} </ref>
* Age less than 15: add one point
* Age greater than 45: subtract one point
 
According to the [[Centers for Disease Control and Prevention]]:
* 0 points: do not test nor treat
* 1 points: do not test nor treat
* 2 points: rapid test and treat if positive
* 3 points
** Option 1: rapid test and treat if positive
** Option 2: treat empirically
* 4 points: treat empirically
 
===Differential diagnosis===
{{r|Angioedema}}
{{r|Angioedema}}
Pharyngitis caused by [[Fusobacterium necrophorum]] may lead to [[Lemierre syndrome]].<ref name="pmid19949147"/>
==Treatment==
==Treatment==
[[Corticosteroid]]s, such as [[prednisone]] 60 mg by mouth for one or two days may reduce symptoms among patients with severe pharyngitis.<ref>{{Cite journal
Antibiotics may be used for patients with sufficient likelihood of streptococcal infection.<ref name="pmid15069046">{{cite journal| author=McIsaac WJ, Kellner JD, Aufricht P, Vanjaka A, Low DE| title=Empirical validation of guidelines for the management of pharyngitis in children and adults. | journal=JAMA | year= 2004 | volume= 291 | issue= 13 | pages= 1587-95 | pmid=15069046 | doi=10.1001/jama.291.13.1587 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15069046  }} </ref>
| doi = 10.1136/bmj.b2976
 
| volume = 339
Losenges with [[amylmetacresol]] and 2,4-dichlorobenzyl alcohol may help.<ref name="pmid19849767">{{cite journal| author=McNally D, Simpson M, Morris C, Shephard A, Goulder M| title=Rapid relief of acute sore throat with AMC/DCBA throat lozenges: randomised controlled trial. | journal=Int J Clin Pract | year= 2010 | volume= 64 | issue= 2 | pages= 194-207 | pmid=19849767
| issue = aug06_2
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=19849767 | doi=10.1111/j.1742-1241.2009.02230.x }} </ref>
| pages = b2976
 
| last = Hayward
[[Corticosteroid]]s, such as [[prednisone]] 60 mg by mouth for one or two days may reduce symptoms among patients with severe pharyngitis.<ref name="pmid19661138">{{cite journal| author=Hayward G, Thompson M, Heneghan C, Perera R, Del Mar C, Glasziou P| title=Corticosteroids for pain relief in sore throat: systematic review and meta-analysis. | journal=BMJ | year= 2009 | volume= 339 | issue=  | pages= b2976 | pmid=19661138
| first = Gail
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19661138 | pmc=PMC2722696
| coauthors = Matthew Thompson, Carl Heneghan, Rafael Perera, Chris Del Mar, Paul Glasziou
}} </ref><ref name="pmid15808038 ">{{cite journal |author=Kiderman A, Yaphe J, Bregman J, Zemel T, Furst AL |title=Adjuvant prednisone therapy in pharyngitis: a randomised controlled trial from general practice |journal=Br J Gen Pract |volume=55 |issue=512 |pages=218–21 |year=2005 |month=March |pmid=15808038 |pmc=1463093 |doi= |url=http://openurl.ingenta.com/content/nlm?genre=article&issn=0960-1643&volume=55&issue=512&spage=218&aulast=Kiderman |issn=}}</ref>
| title = Corticosteroids for pain relief in sore throat: systematic review and meta-analysis
| journal = BMJ
| accessdate = 2009-08-13
| date = 2009-08-06
| url = http://www.bmj.com/cgi/content/abstract/339/aug06_2/b2976
}}</ref><ref name="pmid15808038">{{cite journal |author=Kiderman A, Yaphe J, Bregman J, Zemel T, Furst AL |title=Adjuvant prednisone therapy in pharyngitis: a randomised controlled trial from general practice |journal=Br J Gen Pract |volume=55 |issue=512 |pages=218–21 |year=2005 |month=March |pmid=15808038 |pmc=1463093 |doi= |url=http://openurl.ingenta.com/content/nlm?genre=article&issn=0960-1643&volume=55&issue=512&spage=218&aulast=Kiderman |issn=}}</ref>


==References==
==References==
<references/>
<references/>[[Category:Suggestion Bot Tag]]

Latest revision as of 11:00, 3 October 2024

This article is a stub and thus not approved.
 Main Article
 Discussion
Related Articles  [?]
Bibliography  [?]
External Links  [?]
Citable Version  [?]
 
https://en.citizendium.org/wiki/index.php?title=Pharyngitis&printable=yes
This editable Main Article is under development and subject to a disclaimer.

In medicine, pharyngitis is an upper respiratory tract infection that is "inflammation of the throat (pharynx)."[1]

Causes

Viral

The majority of pharyngtis is caused by viral infection.

Bacterial

Group A β-hemolytic streptococcus (streptococcus pyogenes).

Fusobacterium necrophorum may be as common as group A β-hemolytic streptococcus and can cause Lemierre syndrome.[2] Lemierre syndrome is "suppurative thrombophlebitis of the internal jugular vein, bacteremia, and metastatic infections."</ref>

Chemical and physical agents

Diagnosis

Diagnosis has been reviewed by the Rational Clinical Examination who noted the Centor criteria.[3]

Centor criteria:[4]

  • fever
  • No cough
  • Tonsilar exudate
  • Tender anterior cervical lymph nodes

The McIsaac criteria adds to the Centor:[4]

  • Age less than 15: add one point
  • Age greater than 45: subtract one point

According to the Centers for Disease Control and Prevention:

  • 0 points: do not test nor treat
  • 1 points: do not test nor treat
  • 2 points: rapid test and treat if positive
  • 3 points
    • Option 1: rapid test and treat if positive
    • Option 2: treat empirically
  • 4 points: treat empirically

Differential diagnosis

  • Angioedema [r]: Allergic skin reaction causing localized redness, swelling, and itching. [e]

Pharyngitis caused by Fusobacterium necrophorum may lead to Lemierre syndrome.[2]

Treatment

Antibiotics may be used for patients with sufficient likelihood of streptococcal infection.[5]

Losenges with amylmetacresol and 2,4-dichlorobenzyl alcohol may help.[6]

Corticosteroids, such as prednisone 60 mg by mouth for one or two days may reduce symptoms among patients with severe pharyngitis.[7][8]

References

  1. ↑ Anonymous (2024), Pharyngitis (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ 2.0 2.1 Centor, Robert (2009-12-01). "Expand the Pharyngitis Paradigm for Adolescents and Young Adults". Annals of Internal Medicine 151 (11): 812-815. PMID 19949147. Retrieved on 2009-12-01.
  3. ↑ Ebell MH, Smith MA, Barry HC, Ives K, Carey M (2000). "The rational clinical examination. Does this patient have strep throat?". JAMA 284 (22): 2912-8. PMID 11147989. [e]
  4. ↑ 4.0 4.1 Fine AM, Nizet V, Mandl KD (2012). "Large-Scale Validation of the Centor and McIsaac Scores to Predict Group A Streptococcal Pharyngitis.". Arch Intern Med. DOI:10.1001/archinternmed.2012.950. PMID 22566485. Research Blogging.
  5. ↑ McIsaac WJ, Kellner JD, Aufricht P, Vanjaka A, Low DE (2004). "Empirical validation of guidelines for the management of pharyngitis in children and adults.". JAMA 291 (13): 1587-95. DOI:10.1001/jama.291.13.1587. PMID 15069046. Research Blogging.
  6. ↑ McNally D, Simpson M, Morris C, Shephard A, Goulder M (2010). "Rapid relief of acute sore throat with AMC/DCBA throat lozenges: randomised controlled trial.". Int J Clin Pract 64 (2): 194-207. DOI:10.1111/j.1742-1241.2009.02230.x. PMID 19849767. Research Blogging.
  7. ↑ Hayward G, Thompson M, Heneghan C, Perera R, Del Mar C, Glasziou P (2009). "Corticosteroids for pain relief in sore throat: systematic review and meta-analysis.". BMJ 339: b2976. PMID 19661138. PMC PMC2722696.
  8. ↑ Kiderman A, Yaphe J, Bregman J, Zemel T, Furst AL (March 2005). "Adjuvant prednisone therapy in pharyngitis: a randomised controlled trial from general practice". Br J Gen Pract 55 (512): 218–21. PMID 15808038. PMC 1463093. [e]
Retrieved from "https://citizendium.org/wiki/index.php?title=Pharyngitis&oldid=984654"