Pharyngitis is commonly known as sore throat. It causes inflammation of the pharynx and finally results in a sore throat. Pharyngitis is most commonly referred to as a symptom rather than a condition or disease. Pharyngitis is caused by viruses like rhinovirus, influenza, Adenovirus, Coronavirus, and Parainfluenza virus; and less common viruses include Herpes virus, Epstein-bar virus(EBV), Human immunodeficiency virus (HIV), and Coxsakievirus or bacteria like Group A beta-hemolytic Streptococci, Group B and Group C Streptococci, Mycoplasma pneumonia, Chlamydia pneumonia, Haemophilus influenza, Neisseria meningitides, Neisseria gonorrhoeae, Arcanobacterium hemolyticum, Fusobacterium necrophorum, Corynebacterium diptheriae. Smoking and secondhand smoke, exposure to chemical irritants or close contact with individuals who have pharyngitis increases the risk of pharyngitis. It causes symptoms like sore throat, dry and itchy sensation in the throat, pain during swallowing, fever, pus or white patches on the tonsils, generalized body pains, and fatigue. When pharyngitis is caused by a virus, the symptoms resolve within a week and generally do not require any antibiotics as they work only in the case of pharyngitis caused by bacteria. Pharyngitis caused by Epstein-Bar virus is known as infectious mononucleosis and this condition does not require any antibiotics. Whereas, in the case of pharyngitis caused by bacteria, antibiotics like penicillins shall be prescribed for a short period of 10 days to eradicate the bacteria.
If you suspect you may have Pharyngitis or have risk factors for one, it is crucial to consult with an ENT.
Causes of Pharyngitis
It is caused by either virus or bacteria.
Most common virus that causes pharyngitis include rhinovirus, influenza, Adenovirus, Coronavirus, and Parainfluenza virus; and less common viruses include Herpes virus, Epstein-bar virus(EBV), Human immuno deficiency virus (HIV), and Coxsakievirus.
Bacteria that cause pharyngitis include Group A beta hemolytic Streptococci, Group B and Group C Streptococci, Mycoplasma pneumoniae, Chlamydia pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Neisseria gonorrhoeae, Arcanobacterium haemolyticum, Fusobacterium necrophorum, Corynebacterium diptheriae
Risk Factors of Pharyngitis
Flu season - fall and winter season
Allergies
Day care or crowded schools - viral and bacterial infections spread easily in daycare centers, schools, offices and classrooms.
Individuals who often travel by public transport.
Frequent and severe sinus infections
Smoking or second-hand smoking would cause irritation to the throat
Exposure to chemical irritants
Exposure or close contact with someone who has pharyngitis
Decreased immunity - individuals with HIV, diabetes, asthma,
individuals who are on treatment with steroids or chemotherapeutic agents, and have poor diet.
Symptoms of Pharyngitis
Usual symptoms of pharyngitis include:
Sore throat
Pain, dry  and scratchy sensation in the throat
Pain while swallowing (odynophagia)
Pain while speaking
Swollen glands in the neck area or jaw area
White patches or pus on the tonsils
Myalgia or muscle pains
Generalized weakness
In the majority of cases when pharyngitis is caused by a virus, symptoms include cough, runny nose, pink eye/conjunctivitis, rash and headache.
When pharyngitis is caused by bacteria, symptoms include fever, inflammation of tonsils, enlargement of lymph nodes in the  head and neck(cervical lymphadenopathy)
When pharyngitis is caused by the Epstein bar virus, it is known as infectious mononucleosis.
A few infections that cause sore throat, might lead to other signs and symptoms like fever, cough, runny nose, sneezing, generalized body pains, headache, nausea, and vomiting.
In a few scenarios, pharyngitis could also be a part of some other serious illnesses, which include peritonsillar abscess, retro-pharyngeal abscess, epiglottitis, or Kawasaki disease.
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Diagnosis for Pharyngitis
Diagnosis requires a physical examination by the health care individual and a laryngoscopy to look at the throat, ears, and nasal passages
Examination of the neck, to check for swollen lymph glands Throat swab - culture and sensitivity to check for the Streptococcus bacterial infection.
PCR-based NAAT tests like respiratory panels would be helpful in faster and more accurate diagnosis in case the virus is the cause of the infection.
Treatments for Pharyngitis
Pharyngitis or sore throat caused by the virus usually resolves within 5-7 days and doesn’t require any medications.
Antibiotics shall be prescribed only for Group A beta-hemolytic streptococci positive patients, based on a positive culture of throat swab or sputum culture sensitivity or rapid antigen testing method. A 10-day course of oral penicillins would be recommended to eradicate the bacteria and it would also be helpful in the prevention of rheumatic fever(a condition that causes swelling of the skin, heart, joints, and brain).
Symptomatic treatments like gargling oral acetaminophen, and inhaled steroids would also be recommended.
In the case of infectious mononucleosis(caused by Epstein-bar virus(EBV)), antibiotics should not be used and it is also recommended to avoid any sports for about 6-8 weeks in order to avoid splenic rupture
Preventive Measures for Pharyngitis
Influenza vaccine can be taken once every year in-order to prevent influenza(flu). This can be administered to children aged from 2-17 years. All healthy adults are also recommended to be vaccinated with influenza vaccine annually.
Individuals who are at higher risk for developing serious influenza complications and health care individuals and people who care for individuals with high-risk influenza complications should be vaccinated for sure.
September and October would be generally a good time to be vaccinated for the flu vaccine. But if individuals are at high risk for developing influenza, or have frequent infections, then a vaccine can be taken at any time of the year.
Do's & Don’t's
Do's
Don't
Drink plenty of fluids, like water, herbal teas, or broths.
Avoid smoking or exposure to secondhand smoke.
Gargle with warm salt water several times a day to soothe the throat.
Don't consume alcohol, as it can irritate the throat.
Get plenty of rest to help your body fight off the infection.
Avoid spicy or acidic foods that can further irritate the throat.
Use over-the-counter pain relievers like ibuprofen or acetaminophen to ease throat pain and reduce fever.
Don't share utensils, cups, or toothbrushes to prevent spreading the infection.
Use throat lozenges or hard candies to keep your throat moist and alleviate discomfort.
Avoid clearing your throat frequently, as it can exacerbate irritation.
Practice good hand hygiene by washing your hands frequently with soap and water.
Don't engage in activities that strain your voice, such as yelling or singing loudly.
Consider using a humidifier to add moisture to the air, which can help soothe a sore throat.
Avoid close contact with people who have colds or other respiratory infections.
If prescribed antibiotics, take them exactly as directed by your healthcare provider to treat bacterial infections.
Don't ignore symptoms that worsen or persist for more than a week without improvement.
If you suspect you may have Pharyngitis or have risk factors for one, it is crucial to consult with an ENT.
Any individual having a sore throat that lasts for more than a week, difficulty swallowing, difficulty breathing, throat pain, ear ache, rash, fever of >1010 F, blood in sputum, swelling of the neck, hoarseness of the voice lasting for more than a week or two.
Gargling with warm salt water, drinking warm milk, oral paracetamol incase of severe throat pain could provide symptomatic relief in case of pharyngitis
Infectious mononucleosis is caused by Epstein-Barr virus (EBV), so antibiotics should not be consumed. When oral penicillins are consumed by an individual with infectious mononucleosis it causes morbilliform rash. So, antibiotics should never be consumed incase of infectious mononucleosis.
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