Pharyngitis

Pharyngitis is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Inflammation/infection of the pharynx
  • Third most common complaint for physician visits
  • 30 million cases diagnosed annually
  • Group A β-hemolytic Streptococcus (GAS):
    • Streptococcus pyogenes
    • Unusual in children <3 yr old
    • Cause of 20–30% of childhood pharyngitis
    • Bimodal incidence, highest in ages 5–7 and 12–13 yr
    • Cause of 5–15% of adult pharyngitis
    • Peak months: January–May; also at the start of the school year

Etiology

  • Viral (most common infectious cause [60–80%]):
    • Rhinovirus (20%)
    • Coronavirus (>5%)
    • Adenovirus (5%)
    • Herpes simplex virus (4%)
    • Parainfluenza virus (2%)
    • Influenza virus (2%)
    • Coxsackievirus (<1%)
    • Epstein–Barr virus (<1%)
    • Acute human immunodeficiency virus (HIV)
  • Bacterial:
    • GAS (S. pyogenes [5–30%])
    • Fusobacterium necrophorum (10%)
    • Group C & G β-hemolytic Streptococcus (5%)
    • Neisseria gonorrhea (<1%)
    • Corynebacterium diphtheriae (<1%)
    • Arcanobacterium haemolyticum (<1%)
    • Chlamydia pneumoniae
    • Mycoplasma pneumoniae (<1%)
    • Syphilis
    • Tuberculosis
  • Fungal:
    • Candida (thrush)
  • Chemical burns
  • Foreign bodies
  • Inhalants
  • Postnasal drip
  • Malignancy
  • GERD

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Basics

Description

  • Inflammation/infection of the pharynx
  • Third most common complaint for physician visits
  • 30 million cases diagnosed annually
  • Group A β-hemolytic Streptococcus (GAS):
    • Streptococcus pyogenes
    • Unusual in children <3 yr old
    • Cause of 20–30% of childhood pharyngitis
    • Bimodal incidence, highest in ages 5–7 and 12–13 yr
    • Cause of 5–15% of adult pharyngitis
    • Peak months: January–May; also at the start of the school year

Etiology

  • Viral (most common infectious cause [60–80%]):
    • Rhinovirus (20%)
    • Coronavirus (>5%)
    • Adenovirus (5%)
    • Herpes simplex virus (4%)
    • Parainfluenza virus (2%)
    • Influenza virus (2%)
    • Coxsackievirus (<1%)
    • Epstein–Barr virus (<1%)
    • Acute human immunodeficiency virus (HIV)
  • Bacterial:
    • GAS (S. pyogenes [5–30%])
    • Fusobacterium necrophorum (10%)
    • Group C & G β-hemolytic Streptococcus (5%)
    • Neisseria gonorrhea (<1%)
    • Corynebacterium diphtheriae (<1%)
    • Arcanobacterium haemolyticum (<1%)
    • Chlamydia pneumoniae
    • Mycoplasma pneumoniae (<1%)
    • Syphilis
    • Tuberculosis
  • Fungal:
    • Candida (thrush)
  • Chemical burns
  • Foreign bodies
  • Inhalants
  • Postnasal drip
  • Malignancy
  • GERD

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