Pharyngotonsillitis

Alternative names

Acute pharyngitis. Strep throat.

Definition

Acute infection of the pharynx and palatine tonsils.

The pharynx is a muscular and mucous tube that connects the nose and mouth with the trachea and esophagus. Palatine tonsils, commonly known as angina, are clusters of lymphatic tissue located on both sides of the oropharynx under the soft palate; they constitute the first defensive barrier against pathogenic microorganisms coming from the respiratory tract or the oropharynx.

How does the disease occur?

Pharyngotonsillitis is an infectious disease acquired by contagion, either through the air (coughing or sneezing) or by direct contact (exchange of saliva, contact with contaminated objects, intimate contact)

The most common cause of acute tonsillitis is colonization of the tonsil by viruses that generally affect the respiratory tract; other viruses such as the one responsible for mononucleosis (or kissing disease) herpes or HIV are also causes of tonsillitis.

The second most common cause of is the colonization of the tonsil by bacteria that usually come from the skin, the oropharynx or the respiratory tract. The most common type is strep throat caused by a bacterium known as Streptococcus.

Factors such as drinking cold liquids or eating ice creams, being exposed to drafts, etc; They are not causes of acute pharyngotonsillitis, although they can cause inflammation of the mucosa of the pharynx or tonsil.

Symptoms of illness

The incubation period for the disease ranges from 12 hours to 5 days after the infection occurred. Symptoms vary from patient to patient and can be mild-moderate to severe.

• Gradual onset and progressive worsening
• Moderate fever (generally below 39ºC)
• Moderate sore throat
• Presence of small nodes in the neck
• Redness of the oropharynx and tonsils
• Mild-moderate increase in the size of one or both tonsils.
• Little effect on the general condition.
• It is often accompanied by other respiratory symptoms such as runny nose, cough, and red eyes.

Bacterial pharyngotonsillitis is characterized by:

• Abrupt onset and impairment of the general condition
• High fever (generally higher than 39ºC)
• Increase in the size of the neck ganglia, being painful on palpation.
• Other symptoms such as headache, nausea, vomiting and / or abdominal pain are common.
• Oropharynx and tonsils very red, enlargement of one or both tonsils with the presence on the surface of red dots (small hemorrhages), pockets of pus (bacteria) or whitish plaques.

Diagnosis of the disease

The diagnosis of the disease is based on the symptoms presented by the patient and on the examination of the throat.

On some occasions, it is necessary to carry out complementary diagnostic tests such as a blood test or taking a sample of exudate from the pharynx or tonsil to be able to establish exactly the responsible germ.

Treatment of the disease

Treatment of pharyngotonsillitis produced by viruses is symptomatic through the use of antipyretics-analgesics to control fever and pain. It is advisable to take warm crushed food and cold drinks or at room temperature. Rinses with antiseptic mouthwashes several times a day can prevent colonization of the pharynx or tonsils by bacteria.

The treatment of pharyngotonsillitis produced by bacteria requires the use of a specific antibiotic against the germ causing the infection, in addition to symptomatic treatment through the use of antipyretic-analgesics to control fever and pain. It is advisable to take warm crushed food and cold drinks or at room temperature.

Infections that present with a significant impairment of the general condition or with difficulty for the passage of air through the oropharynx require hospital admission for treatment.

Surgical removal of the tonsil, tonsillectomy, is reserved for highly selected patients.

Prognosis of the disease

Most pharyngotonsillitis have a good prognosis and usually resolve within 7-10 days with adequate treatment.

Pharyngotonsillitis caused by viruses usually resolves spontaneously within a few days without leaving sequelae.

Bacterial pharyngotonsillitis usually resolves with appropriate antibiotic treatment within a few days. Untreated strep throat can lead to rare complications such as rheumatic fever or acute glomerulonephritis.