Pharyngitis - symptoms, diagnosis, and treatment

Pharyngitis is an inflammatory process in the mucous membrane, lymphoid tissue and pharyngeal glands. The most common clinical manifestations are pain and sore throat. Everyone has faced this problem at least once in their lifetime.

Short information about pharyngitis

Pharyngitis classification

Pharyngitis is acute and chronic.

The acute form of the process, as a rule, occurs as a result of mucosal burns (both chemical and thermal), extensive and infectious pathologies.

Chronic pharyngitis develops against the background of an untreated acute process. As a separate disease, it is formed with prolonged contact of the mucosa with slowly acting irritants.

Chronic disease, in turn, is:

- Catarrhal (inflammation will not change the structure of mucosal tissues in any way, it develops in the initial stages of chronic pharyngitis);
- Granular (manifested by a tickling feeling in the throat, granules (accumulations of lymphoid tissue) on the pharyngeal mucosa increase);
- Purulent (the granules are inflamed, there is swelling, ulcers and purulent plaque appear);
- Atrophic (the mucous membrane becomes thinner, the secretory function is disturbed; this form is dangerous for the development of infectious complications);
- Hypertrophic (inflammation mainly affects the lymphoid tissue on the back of the pharynx, causing redness, growth, swelling; there is an increase in the tonsils and lymph nodes located in the neck).

Due to the appearance of the disease, pharyngitis is:

- Infectious (can be caused by viruses, bacteria, fungi);
- Allergic;
- Traumatic.

Etiology (causes) of the disease

The most common causes of pharyngitis are:

- Transition of infection into the pharynx from neighboring foci of unhealthy processes (teeth, sinuses);
- Traumatization (ingress of a foreign body and its extraction, surgical intervention);
- Inhalation of chemical vapors;
- Smoking (not only tobacco);
- Bacterial infections;
- Hypovitaminosis (vitamins deficiency);
- Exposure to radiation;
- Fungal infections (candidiasis);
- General hypothermia;
- Viral pathologies;
- Diseases of other organs and systems of the body (most often, the cause of pharyngitis is diseases of the digestive system, circulatory system);
- Ingress of excessively cold or hot air into the oral cavity;
- Immunodeficiency states.

Chronic atrophic pharyngitis is often observed in elderly people due to age-related changes in the pharyngeal mucosa.

Infection routes

The causative agent of bacterial pharyngitis is often hemolytic streptococcus. The disease is transmitted from person to person by airborne droplets and through direct contact.

Clinical picture

Pharyngitis symptoms differ depending on the form and stage of the disease. However, the main signs of pharyngitis are distinguished, which appear gradually during the development of an unnatural process:

- Perspiration and dryness;
- Hoarse voice;
- Chills;
- Increased body temperature;
- Weakness and signs of intoxication (as in viral diseases);
- Feeling of tightness and foreign object in the throat;
- Enlarged lymph nodes;
- Accumulation of mucus;
- Cough that gets worse in the morning (may be accompanied by nausea);
- Swelling in the throat, which is worse when swallowing;
- Persistent desire to swallow or cough up (sometimes the condition is accompanied by a gag reflex);
- Purulent discharge.

Features of the course during pregnancy

Pharyngitis is especially dangerous during pregnancy. The woman's body works more actively, and such a load on the immune system is fraught with an increased risk of inflammatory, viral and other diseases. Common symptoms of pharyngitis are weakness, fever, body intoxication, which adversely affect the health of the fetus. The disease can lead to a decrease in respiratory function, which, in turn, leads to fetal hypoxia and irreversible pathological changes.

Since pregnant women are prohibited from taking most drugs, self-medication for pharyngitis during pregnancy is unacceptable. For adequate treatment of pharyngitis, consultation with an otolaryngologist and a family doctor is required.

Features of the course of the disease in children

Pathology develops in the same way in patients of any age. But, in childhood, the disease has a number of characteristic symptoms. The main difference is the fact that pharyngitis in children as an independent disease is extremely rare. It mainly develops as a complication of a viral infection. Treatment of pharyngitis in children involves the diagnosis of the underlying disease, as well as complex therapy for both the underlying pathology and pharyngitis. The treatment of the disease in children should be dealt with by a pediatric ENT doctor or pediatrician.

Complications of pathology

Pharyngitis is diagnosed quite often and responds well to treatment. But in the absence of treatment, acute pharyngitis becomes chronic, which is characterized by periods of exacerbation and remission. As a result, the mucous membrane atrophies, ceases to perform its function and becomes a focus of infection throughout the body. Also, irreversible changes in the cardiovascular system or even cancer may develop.

Possible complications of pharyngitis:

- Paratonsillar abscess (acute purulent inflammation in the periaminal tissue);
- Retropharyngeal abscess (the abscess is located in the pharyngeal region and on the lymph nodes);
- Chronic bronchitis;
- Tracheitis (inflammation of the trachea);
- Laryngitis (damage to the laryngeal mucosa);
- Inflammation of the auditory tube;
- Acute articular rheumatism (more common in children from 6 years of age);
- Meningitis;
- Cervical lymphadenitis, etc.

Diagnostics

Pharyngitis diagnosis begins with a physical examination of the patient. On visual examination, the posterior pharyngeal wall is reddened or pale (with an atrophic form of the disease), there are accumulations of mucus (sometimes, with the inclusion of pus). The uvula and soft palate are denser, enlarged granules are visualized. Atrophic pharyngitis is characterized by a thin, dry shell with a varnish surface. On palpation of the neck, enlarged lymph nodes are palpated.

Among the instrumental methods are used:

- Pharyngoscopy (performed using a laryngopharyngoscope equipped with a camera and a light guide, during the procedure a biopsy can be performed);
- Bacterial culture of a swab from the pharyngeal mucosa.

Differential diagnosis of pharyngitis is carried out with acute tonsillitis. The main difference between these two pathologies is the presence of cough, runny nose, conjunctivitis with pharyngitis, which are not observed in patients with tonsillitis.

Treatment of the disease

Pharyngitis treatment directly depends on the nature of the disease and involves an integrated approach. First of all, therapy involves refusal to take irritating food (hot, cold, spicy, salty), smoking, alcohol. It is recommended to drink plenty of fluids (up to 2 liters per day), as well as gargle with anti-inflammatory and antiseptic solutions.

Drug treatment

Antiviral drugs are recommended for the treatment of viral pharyngitis. At a high temperature, drugs are prescribed that contain paracetamol or ibuprofen. When diagnosed with bacterial pharyngitis, antibiotic therapy is required. An antibiotic is prescribed based on the results of bacterial culture and analysis for the sensitivity of the pathogen. For instance, the medication of choice can be Cefaclor.

Physiotherapy

Heat inhalations, warming compresses, electrophoresis have shown high efficiency in the treatment of pharyngitis.

Surgery

In advanced conditions, when drug therapy does not help and purulent inclusions on the mucous membrane are observed, abscesses are present, surgical intervention is recommended (cryoapplication, coagulation of granules).

Laser surgery for pharyngitis is a minimally invasive method of therapy that does not require a long rehabilitation period. High temperatures, acting on the focus of pathology, simultaneously cauterize the site of the operation, preventing bleeding and infection.

Prevention

Prevention of pharyngitis includes a number of simple measures that will help not only prevent the disease, but also strengthen the body:

- Giving up smoking;
- Good nutrition;
- Healthy lifestyle – regular physical activity;
- Timely treatment of diseases;
- Avoiding spending much time in dusty areas (or, if this cannot be avoided, if possible, use a respirator);
- Monitoring the state of the immune system and supporting it with vitamins and minerals when needed.

Post by: Rachel Lewis, Senior Medical Advisor at Medibank, Sydney, New South Wales, Australia