Acute Pharyngitis
- Viral: Respiratory viruses typically cause mild disease associated with nonspecific URI symptoms, tender cervical adenopathy, and minimal fever. Influenza virus and adenovirus can cause severe exudative pharyngitis with fever. Herpes simplex virus (HSV) causes pharyngeal inflammation and exudates with vesicles and ulcers on the palate. Coxsackievirus A causes small vesicles on the soft palate and uvula that form shallow white ulcers. Epstein-Barr virus and cytomegalovirus cause exudative pharyngitis in association with other signs of infectious mononucleosis. HIV causes fever, myalgias, malaise, and sometimes a maculopapular rash.
- Bacterial: Group A Streptococcus (GAS) accounts for ~5-15% of cases of pharyngitis in adults but is primarily a disease of children 5-15 years old. Other bacterial causes include streptococci of groups C and G, Neisseria gonorrhoeae, Corynebacterium diphtheriae, and anaerobic bacteria. Streptococcal pharyngitis ranges from mild disease to profound pharyngeal pain, fever, chills, abdominal pain, and a hyperemic pharyngeal membrane with tonsillar hypertrophy and exudates. Coryzal symptoms are absent. The diagnosis is made by rapid antigen-detection testing for GAS. Most experts recommend that children have a throat culture performed if rapid testing is negative, but this course is not recommended for adults because of the low incidence of disease. For treatment options in adults, see Table 62-1 and Chap. 94. (Regimens for children can be found in Table 31-3 in HPIM-17.)
Infections of the Pharynx and Oral Cavity has been found in Harrison's Manual of Medicine 17/e
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