Acute pharyngitis
The content of the article:
- Causes and risk factors for acute pharyngitis
- Forms of the disease
- Symptoms of acute pharyngitis in adults
- Features of acute pharyngitis in children
- Diagnostics of the acute pharyngitis
- Treatment of acute pharyngitis
- Possible complications and consequences of acute pharyngitis
- Forecast
- Prevention of acute pharyngitis
Acute pharyngitis is an acute inflammatory disease of the pharyngeal cavity, provoked by exposure to infectious agents or physical factors. Inflammatory changes in this disease diffusely affect the mucous membrane of the organ, the tissue of the lymphadenoid formations is not damaged, in contrast to acute tonsillitis, when the lymphoid tissue of the tonsils is the morphological substrate.
Acute pharyngitis can either be an independent pathology or act as one of the manifestations of certain diseases. The greatest prevalence of the disease is noted in children (annually up to 7 million recorded visits), the incidence among adult patients is much lower.
Most uncomplicated cases of acute pharyngitis belong to the so-called self-resolving, that is, they stop on their own and do not require the appointment of special therapy.
Symptoms of acute pharyngitis
Causes and risk factors for acute pharyngitis
The vast majority of cases of acute pharyngitis are provoked by viruses, they account for more than 2/3 of all cases:
- rhinovirus (the bulk of viral pharyngitis);
- coronavirus;
- respiratory syncytial virus;
- adenovirus;
- influenza and parainfluenza viruses;
- Epstein-Barr virus; and etc.
In addition to viruses, acute pharyngitis can be provoked by:
- β-hemolytic streptococcus of group A (more than a third of cases of acute pharyngitis in children and up to 17% of the total mass of diseases in adult patients), C and G (much less often);
- anaerobic microorganisms;
- corynebacteria;
- fusobacteria;
- Yersinia;
- neisseria;
- mycoplasma;
- chlamydia;
- mushrooms of the genus Candida; etc.
The bulk of bacterial pharyngitis is caused not by an isolated effect of a separate pathogenic microorganism, but by a combined effect (2-3 or more pathogens).
Acute pharyngitis can be not only infectious in nature, but also caused by the influence of aggressive environmental factors:
- respiratory allergens;
- volatile chemical compounds (vapors of acids, alkalis, aromatic hydrocarbons);
- exposure to ionizing radiation;
- inhalation of hot vapors;
- trauma to the pharyngeal mucosa;
- the consequences of the transferred surgical intervention.
Acute pharyngitis: infectious causes and signs
An important role in the development of acute pharyngitis in adults and children is played by the impact on the body of risk factors:
- bad habits (smoking, alcohol abuse);
- chronic infectious diseases of the ENT organs;
- a chronic focus of infection in the dentition;
- violation of nasal breathing, the habit of breathing through the mouth;
- decrease in the general resistance of the body (acute diseases, postoperative period, hypothermia, acute psycho-emotional breakdowns);
- the effect of local cold on the tissues of the pharynx;
- violation of food hygiene (abuse of spicy and excessively hot food, carbonated drinks, seasonings that irritate the mucous membrane of the pharynx);
- industrial hazards, especially in cases of neglect of safety rules when working with volatile, poisonous compounds;
- unfavorable ecological situation;
- unsatisfactory microclimate in residential premises (dampness, high level of humidity, insufficient heating of premises).
Forms of the disease
Depending on the cause of the inflammatory process, acute pharyngitis can be of the following types:
- bacterial;
- viral;
- mycotic (fungal);
- allergic;
- traumatic;
- provoked by aggressive physical and chemical factors of the external environment.
Symptoms of acute pharyngitis in adults
The symptoms of acute pharyngitis are very characteristic:
- a sudden onset of the disease with an acute pain syndrome, the pain often radiates to the ear, lower jaw (the severity of pain is explained by the intense innervation of the pharyngeal mucosa);
- maximum severity of pain in the so-called empty throat (swallowing saliva), characterized by a decrease in the intensity of pain after drinking (several swallowing movements in a row);
- the equivalent of a pain syndrome may be local discomfort - perspiration, scratching, sore throat;
- an increase in body temperature to subfebrile numbers (rarely above 38-38.5 ºС);
- hyperemia, swelling of the mucous membrane, punctate hemorrhages in the area of the hard palate;
- the presence of mucous or mucopurulent secretions on the back of the pharynx, hypertrophy of individual follicles is possible;
- increase and tenderness on palpation of regional lymph nodes (submandibular, parotid, posterior cervical);
- general intoxication symptoms (headache, dizziness, drowsiness, apathy, decreased performance) are poorly expressed, the general well-being in most cases suffers slightly.
In acute pharyngitis, the patient is worried about a sore throat when swallowing saliva
Features of acute pharyngitis in children
The manifestations of acute pharyngitis in children have a number of characteristic features: the clinical picture in the child is more detailed, the symptoms of the disease are pronounced, there are active signs of intoxication.
In isolation, the disease rarely occurs, more often accompanied by respiratory viral infections. Children are characterized by diffuse inflammation of the pharyngeal mucosa with frequent involvement of the palatine tonsils (tonsillopharyngitis), rather rapid migration of the inflammatory process into the larynx, larynx, trachea.
Acute pharyngitis of a bacterial nature, provoked by group A β-hemolytic streptococcus, is observed more often in the age group from 5 to 15 years - antibiotic therapy in children is due only in this case.
The prevalence of acute streptococcal upper respiratory tract infection in the age group under 3 years varies within 10-14%, according to some researchers, does not exceed 6%.
In children, the clinical picture of acute pharyngitis is more detailed than in adults
Diagnostics of the acute pharyngitis
Diagnosis of the disease, as a rule, does not cause difficulties and is based on an assessment of the clinical picture and laboratory data:
- a general blood test (leukocytosis with a neutrophilic shift to the left, accelerated ESR; if the cause of acute pharyngitis is infectious mononucleosis - the initial decrease in the number of leukocytes is replaced by severe leukocytosis (up to 20-30 x 10 9 / l), up to 90% of the leukocyte formula is performed by mononuclear cells and atypical lymphocytes);
- biochemical blood test (acute phase indicators);
- sowing the material of the pharyngeal cavity on a nutrient medium in order to isolate group A β-hemolytic streptococcus;
- determination of streptococcal antigen in smears by agglutination;
- immunodiagnosis of increased titers of anti-streptococcal antibodies.
Diagnosis of acute pharyngitis does not cause difficulties due to the vivid clinical picture
Detection of β-hemolytic group A streptococcus in the materials of a smear from the pharyngeal cavity is carried out in order to determine the tactics of treatment, since in this case antibiotic therapy is necessary. This type of microorganism is the most pathogenic of the group of streptococci, capable of provoking a number of serious infectious and inflammatory diseases, therefore, its timely detection and eradication is necessary to prevent the development of secondary complications.
Treatment of acute pharyngitis
Treatment of acute pharyngitis is carried out comprehensively, uncomplicated acute pharyngitis antibacterial treatment, as a rule, does not require:
- fortified diet;
- plentiful drink;
- antiviral drugs, immunostimulants;
- aerosols, antiseptic sprays;
- rinsing with antiseptic solutions, phytopreparations;
- local anesthetics;
- with an increase in body temperature - antipyretic drugs.
Preparations for topical use - lozenges and tablets for resorption - have proven themselves well in the treatment of sore throat, and preparations of a complex composition are more preferable. For example, the drug Anti-Angin® Formula lozenges / lozenges, which include chlorhexidine, which has a bactericidal and bacteriostatic effect, tetracaine, which has a local anesthetic effect and vitamin C. Due to its complex composition, Anti-Angin® Formula has a triple effect: it helps fight bacteria, help relieve pain and help reduce inflammation and swelling. 1,2
Anti-Angin® Formula is presented in a wide range of dosage forms: spray, lozenges and lozenges. Anti-Angin® Formula is indicated for the prevention and treatment of infectious and inflammatory diseases of the pharynx (including the manifestations of tonsillitis, pharyngitis and the initial stage of angina).
Anti-Angin® Sugar-free lozenge formula *
The appointment of antibacterial drugs for acute pharyngitis is indicated only with the addition of a secondary infection, the appearance of symptoms of lacunar or follicular tonsillitis. The duration of the course of treatment in this case is 7-10 days. Antibiotic therapy begins with semi-synthetic protected penicillins, 2nd and 3rd generation cephalosporins. In case of their intolerance, macrolides (azalides) are recommended.
The ineffectiveness of treatment is evidenced by active symptoms that persist for 2-3 days against the background of ongoing therapy, the absence of positive dynamics. In this situation, it is necessary to replace the antibacterial drug.
Drinking plenty of fluids and antiviral therapy are the basis for the treatment of acute pharyngitis
Criteria for the effectiveness of the pharmacotherapy of acute pharyngitis:
- subsiding pain syndrome, reducing discomfort when swallowing;
- reduction of hyperemia of the mucous membrane;
- reduction of the inflammatory response of regional lymph nodes.
Possible complications and consequences of acute pharyngitis
Acute pharyngitis can have the following complications:
- tonsillopharyngitis;
- paratonsillar abscess;
- paratonsillitis;
- mediastinitis;
- transformation of acute pharyngitis into a chronic form.
Forecast
With timely diagnosis and complex treatment, the prognosis is favorable.
Prevention of acute pharyngitis
- Avoiding hypothermia.
- Timely treatment of diseases of the ENT organs.
- Oral cavity sanitation.
- Carrying out hardening activities.
- Quitting smoking, alcohol abuse.
- Compliance with safety regulations, the use of personal protective equipment when working in hazardous production.
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* With caution in diabetes mellitus, contains ascorbic acid.
1. Instructions for use of the drug Anti-Angin® Formula in the dosage form of a lozenge.
2. Instruction for use of the Anti-Angin® Formula in the dosage form of a tablet for resorption.
There are contraindications. Consult a specialist before use.
Olesya Smolnyakova Therapy, clinical pharmacology and pharmacotherapy About the author
Education: higher, 2004 (GOU VPO "Kursk State Medical University"), specialty "General Medicine", qualification "Doctor". 2008-2012 - Postgraduate student of the Department of Clinical Pharmacology, KSMU, Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
