Disease sexually transmitted:



  • What is Pharyngitis
  • What triggers / Causes of Pharyngitis
  • The Symptoms Of Pharyngitis
  • Diagnosis Of Pharyngitis
  • Treatment Of Pharyngitis
  • Prevention Of Pharyngitis
  • Which doctors should be consulted if You have Strep throat

What is a Strep

Pharyngitis - acute or chronic inflammation of the mucous membrane of the pharynx, which is accompanied by pain, itching or discomfort in the throat.
Because anatomically, the pharynx is divided into three sections – upper (nasopharynx), medium (oropharynx) and lower (hypopharynx), inflammatory processes, developing here, can also be classified according to their predominant localization. However, the division it will be highly conditional, especially in acute pharyngitis, due to the fact that acute viral and bacterial infections diffuse amaze mucosa of the upper respiratory tract and are highly migratory, often top-down in nature. Morphological changes of the mucosa in chronic pharyngitis usually have a preferential localization in one of the anatomical divisions of the pharynx, which allows a degree of conditionality to allocate a separate nosology, for example, chronic nasopharyngitis.

What triggers / Causes of Pharyngitis:

The main cause of pharyngitis - inhalation of cold or polluted air, the effect of chemical stimuli (alcohol, tobacco). Infectious pharyngitis can be triggered by a variety of microbes (strepto-, stafilo-, pneumococci, and viruses (influenza, adenovirus) and fungi (Candida). Pharyngitis often develops due to spread of infection from any source of inflammation, adjacent to the throat. So developing pharyngitis sinusitis, rhinitis, dental caries.
The etiological factor of acute pharyngitis can be divided into viral, bacterial, fungal, allergic, traumatic (a consequence of foreign body or surgical intervention) and due to exposure to irritants (hot liquid or steam, acids, alkalis, irradiation, etc.). Chronic pharyngitis is usually not classified according to etiological basis, and the nature of developing in the lining of changes: catarrhal (simple), atrophic (subatrophic) and hypertrophic. These forms of chronic inflammation are often combined. Thus, the presence of diffuse atrophic changes in the mucosa may be associated with focal hyperplasia of lymphoid tissue of the posterior wall of the pharynx or tuboperitoneal rollers.
Classification pharyngitis
• Viral
• Bacterial
• Fungal
• Allergic
• Traumatic
• Due to exposure to irritants
• Chronic
Simple (catarrhal)
• Hypertrophic (granulosa)
• Atrophic
• Mixed form
The most common form of acute inflammation of the mucous membrane of the throat is catarrhal pharyngitis with SARS. It is known that about 70 of pharyngitis are caused by viruses, among which are noted by rhinoviruses, coronaviruses, respiratory syncytial virus, adenovirus, influenza viruses and parainfluenza. The most common causative agent of acute pharyngitis are rhinoviruses. Recent studies show that their importance is growing rapidly and now rhinoviruses responsible for more than 80 cases of SARS in the period of autumn epidemics. Viral infection is often just the first phase of the disease, and it "paves the way" for subsequent bacterial infection.
Viruses are the causative agents of acute pharyngitis (in descending order of frequency):
• Rhinoviruses
• Coronaviruses
• Adenoviruses
• The flu virus
• Parainfluenza virus
• Respiratory syncytial virus
• Herpes simplex virus (types 1 and 2)
• Enteroviruses
• Coxsackie Virus
• Epstein–Barr
• Cytomegalovirus
• Human immunodeficiency virus
These aggregated data from foreign guides otorhinolaryngology and infectious diseases, rather conventional, since the term "sore throat", used in English (Russian equivalent – acute pharyngitis or pharyngotonsillitis), is not a specific disease entity, but rather a collective term for several diseases. In addition to non-specific forms, there are other types of pharyngitis associated with specific pathogens, for example, Epstein–Barr infectious mononucleosis, Yersinia enterocolitica in yersenioses and gonococcus with gonorrheal pharyngitis and Leptotrix buccalis when leptotrichia pharynx.jpg" alt="Pharyngitis" />

The Symptoms Of Strep Throat:

For the clinical picture of acute pharyngitis characterized by irritation, dryness, discomfort and pain in the throat when swallowing (especially when it is empty throat), at least – malaise, temperature rise. When inflammation tuboperitoneal rolls pain usually radiates to the ears. Palpation may experience soreness and increase the upper cervical lymph nodes. When pharyngoscope visible hyperemia posterior pharyngeal wall and Palatine arches, separate inflamed lymphoid granules, but no typical for angina signs of inflammation of the tonsils. Remember that strep throat can be the first manifestation of some infectious diseases: measles, scarlet fever, German measles. In some cases, require differential diagnosis of Kawasaki disease and syndrome of Stevens–Johnson.
For the clinical picture of chronic pharyngitis is not typical temperature increase and a significant deterioration of the General condition. Sensations patients are characterized as dry, scratchy and the feeling of a lump in the throat that causes the urge to cough or "clear my throat". The cough is usually persistent, dry and easily distinguished from cough, accompanying for tracheobronchitis. Discomfort in the throat is often associated with forced the need to constantly swallow on the back of the throat mucus, making patients irritable, interferes with their normal activities and disrupts sleep.
In atrophic pharyngitis pharyngeal mucosa looks thinning, dry, often covered with dried mucus. The shiny surface of the mucosa can be seen injected vessels. In hypertrophic form pharyngoscope reveals foci of hyperplastic lymphatic tissues randomly scattered on the back of the throat or enlarged tuboperitoneal rollers, located behind the rear palatal handles. At the time of exacerbation of these changes are accompanied by hyperemia and edema of the mucosa, usually, however, the paucity of objective findings is not consistent with the severity of the symptoms, disturbing patients.
Chronic pharyngitis is often not an independent disease, but a manifestation of the pathology of the gastrointestinal tract: chronic atrophic gastritis, cholecystitis, pancreatitis. The ingress of acidic gastric contents into the throat during sleep with gastroesophageal reflux disease and hernia hiatal is often a hidden cause of chronic catarrhal pharyngitis, and in this case without addressing the root cause of the disease any local methods of treatment are insufficient and short-lived effect. Smoking and tonsillectomy lead to the development of atrophic changes in the mucosa of the pharynx.
Pharyngitis often develops when constantly difficult nasal breathing. It can be caused not only by the transition to breathing through the mouth, but also abuse vasoconstrictor drops, which flow down from the nasal cavity into the throat and render unnecessary analiziruyuschei effect. The symptoms of pharyngitis may be present at the so-called postnasal syndrome (an English term – "postnasal drip"). In this case, discomfort in the throat associated with runoff pathological secretion from the nasal cavity or paranasal sinuses at the back of the throat. In addition to constant coughing this condition can cause in children, the appearance of the sibilant rale, requiring differential diagnosis of bronchial asthma.
The main factors contributing to the development of chronic pharyngitis:
• constitutional peculiarities of the structure of the mucous membrane of the pharynx and the gastro–intestinal tract-
• prolonged exposure to exogenous factors (dust, hot, dry or smoky air, chemicals)-
• shortness of nasal breathing (breathing through the mouth, the overuse of decongestants)-
• Smoking and alcohol abuse-
• Allergy-
• endocrine disorders (menopause, hypothyroidism, etc.) -
• vitamin A-
• diabetes, cardiac, pulmonary and renal failure.
When persistent, are not amenable to conventional therapy sore throat requires differential diagnosis with a number of syndromes in developing some systemic diseases and diseases of the nervous system. Syndrome Plummer–Vinson occurs in women aged 40 to 70 years due to iron deficiency anemia. Sjögren's syndrome is autoimmune disease involving, in addition to severe dryness of mucous membranes of the gastrointestinal tract, diffuse increase in the salivary glands. For Eagle syndrome (stillway) is characterized by strong permanent, often unilateral pain in the throat caused by elongation of the styloid process, which is located on the lower surface of the temporal bone and may be the lesions over the upper pole of the Palatine tonsil. A variety of neuralgia (glossopharyngeal or vagus nerve) can also be the cause of pain in the throat, especially in the elderly.

Diagnosis Of Pharyngitis:

Inspection, if necessary: bacteriological or virological examination (smear from the throat).

Treatment Of Pharyngitis:

For acute and exacerbation of chronic pharyngitis, is not accompanied by functional disturbances of the General condition, it is enough to symptomatic treatment, including sparing diet, hot foot bath, hot compress on the front surface of the neck, milk with honey, steam inhalation and gargling. Smoking should be discontinued. Uncomplicated pharyngitis usually do not require systemic antibiotics. In this situation, it is reasonable to conduct systemic and local antimicrobial therapy, which can be assigned, and as monotherapy. However, a survey conducted in Belgium showed that, in General, with SARS and sore throat for prescribing antibiotics uses 36 doctors.
The composition of antibacterial drugs for the treatment of pharyngitis typically include one or more antiseptic (chlorhexidine, hexetidine, benzydamine, Amazon, thymol and its derivatives, alcohols, iodine, etc.), essential oils, local anesthetics (lidocaine, tetracaine, menthol) rarely – antibiotics (fusafungine, framycetin) or sulfonamides, deodorizing means. The preparations may also contain bacterial lysates (Imudon), natural antiseptics (plant extracts, bee) synthesized nonspecific factors of protection of the mucous membranes, with even and antiviral activity (lysozyme, interferon), vitamins (ascorbic acid).
Antimicrobial drugs can be administered in the form of a rinse, insufflate, inhalation, and tablets and lozenges for sucking. The main requirements applied to the mucosa of drugs are:
• broad spectrum of antimicrobial activity, preferably including antiviral and antimicrobial activity
• no toxic effect and low rate of absorption from the mucous membranes-
low allergenicity-
• no irritating to the mucous.
Most of the drugs (exelis, drill, septolete, Abd faringosept neo–sore throats, Strepsils, etc.) available in the form of tablets, lozenges, or lozenge. This form of medicines has a relatively low activity, and their function is limited mild forms of the disease. In addition, the doctor should be aware of the toxicity of chlorhexidine, which is a part of many drugs (antiagin, drill, sabadin, eludril) and not allow them unlimited uncontrolled patients (especially children).
The appointment of a number of drugs limits their high allergenicity and irritating. These include preparations containing iodine derivatives (Iodinol, jocks, vicadin, povidone–iodine), propolis (proposol), sulfonamides (bikerman, ingalipt). Drugs, containing vegetable antiseptics and essential oils that are effective and harmless, but their purpose is contraindicated in patients who are allergic to pollen, and the number of persons with this disease in certain geographical zones up to 20 in the population.
Inhaled antibiotic fusafungine (Bioparox) – a drug that combines the antibacterial properties with anti-inflammatory and produced in the form of metered-dose aerosol is used in the treatment of respiratory tract infections over 20 years. Due to the very small size of aerosol particles fusafungine able to penetrate into the most inaccessible respiratory tract and to provide there own therapeutic effect. High antimicrobial efficacy fusafungine in acute pharyngitis, laryngitis and tracheobronchitis confirmed by a large number of observations. Spectrum of antimicrobial activity fusafungine adapted to the microorganism, most often the causative agents of infections of the upper respiratory tract, when it is active and Mycoplasma infection. The unique quality of this drug is the stability spectrum: its use is not marked the emergence of new resistant thereto strains of bacteria. In addition to antibacterial properties, fusafungine has its own anti-inflammatory activity which has been demonstrated in experimental studies. It enhances macrophage phagocytosis and inhibits the formation of inflammatory mediators. This explains the effectiveness of the drug in viral pharyngitis, although a direct inhibitory effect on the virus, the drug has not. When assigning fusafungine noted smoother for after tonsillectomy.
Imudon fundamentally different from all products applied for local treatment of pharyngitis. It is a multivalent antigen complex, which consists of lysates 10 bacteria and two fungal pathogens infections (Candida albicans and Fusiformis fusiformis), often causing inflammation in the mouth and in the throat. Imudon activates phagocytosis, increases the number of immune cells, increases the content of lysozyme and secretory IgA in saliva. The data showed that the appointment of Imudon in acute, as well as catarrhal, hypertrophic and subatrophic forms of chronic pharyngitis is more effective than traditional methods of treatment such as inhalation of alkaline and antibacterial agents, burning pellets with a solution of silver nitrate and the use of other anti-inflammatory and analgesic drugs. If necessary, Imudon combines well with local or systemic antibiotics, contributing to shorten the recovery and maintenance of local immune protection, which is especially important in antibiotic therapy. Imudon comes in the form of tablets for sucking.
Hexetidine (Hexoral) offered both as a mouthwash and spray. Unlike chlorhexidine drug has low toxicity. It is active against most bacteria – pathogens of pharyngitis and tonsillitis, and fungi. In addition to antimicrobial, hexetidine has hemostatic and analgesic effect, which justifies its use not only after tonsillectomy and opening paratonsillar abscess, but after extensive operations in the throat (eg operations with obstructive sleep apnea, etc.). The combination of the above-mentioned effects with a deodorizing effect of the drug is beneficial for patients with tumors of the upper respiratory tract, in particular receiving radiation therapy.
Antiseptic for mucous membranes of octenisept has perhaps the widest range of antimicrobial activity covering gram-positive and gram-negative bacteria, chlamydia, Mycoplasma, fungi, protozoa, and viruses of herpes simplex, hepatitis b and HIV. The action of the drug starts within a minute and lasts for hours. Octenisept is not toxic and is not absorbed through the intact mucosa. Use a solution of octenisept, spraying this solution on mucous membranes with the help of insufflator. Of course, the main drawback of this drug is that it is not available in forms convenient for self-application, and its use is largely limited to practice until specialized departments.
Local antibacterial agents can be widely applied in the treatment of pharyngitis. The optimal choice of drug is determined by its spectrum of antimicrobial activity, lack of allergenicity and toxic effects. Of course, the most effective local drugs will not completely replace needs in systemic administration of antibiotics for tonsillitis and pharyngitis caused by beta-hemolytic Streptococcus. On the other hand, in connection with non-bacterial etiology of many forms of pharyngitis, the emergence of a growing number of resistant strains of bacteria, and unwanted effects of a common antibiotic local prescribing drugs with a broad spectrum of antimicrobial activity in many cases is the method of choice.

Prevention Of Pharyngitis:

Hardening of the body, the elimination of harmful factors (Smoking, alcohol use), restoration of nasal breathing, increase the body's defenses (the use of drugs, immunomodulators, IRS-19).

Which doctors should be consulted if You have Strep throat:

More in this category: « Acute nasopharyngitis (common cold) Streptococcal pharyngitis »

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