Pharyngitis is inflammation of the back of the throat, known as the pharynx. It typically results in a sore throat and fever. Other symptoms may include a runny nose, cough, headache, difficulty swallowing, swollen lymph nodes, and a hoarse voice. Symptoms usually last 3–5 days. Complications can include sinusitis and acute otitis media. Pharyngitis is a type of upper respiratory tract infection.Most cases are caused by a viral infection. Strep throat, a bacterial infection, is the cause in about 25% of children and 10% of adults. Uncommon causes include other bacteria such as gonorrhea, fungus, irritants such as smoke, allergies, and gastroesophageal reflux disease. Specific testing is not recommended in people who have clear symptoms of a viral infection, such as a cold. Otherwise, a rapid antigen detection test (RADT) or throat swab is recommended. Other conditions that can produce similar symptoms include epiglottitis, thyroiditis, retropharyngeal abscess, and occasionally heart disease.NSAIDs, such as ibuprofen, can be used to help with the pain. Numbing medication, such as topical lidocaine, may also help. Strep throat is typically treated with antibiotics, such as either penicillin or amoxicillin. It is unclear whether steroids are useful in acute pharyngitis, other than possibly in severe cases, but a recent (2020) review found that when used in combination with antibiotics they moderately improved pain and the likelihood of resolution.About 7.5% of people have a sore throat in any 3-month period. Two or three episodes in a year are not uncommon.
Antibiotics are effective in the early stages, but recovery is generally slow. OthersA few other causes are rare, but possibly fatal, and include parapharyngeal space infections: peritonsillar abscess ("quinsy abscess"), submandibular space infection (Ludwigs angina), and epiglottitis. Fungal
Some cases of pharyngitis are caused by fungal infection, such as Candida albicans, causing oral thrush. Noninfectious
Pharyngitis may also be caused by mechanical, chemical, or thermal irritation, for example cold air or acid reflux. Some medications may produce pharyngitis, such as pramipexole and antipsychotics. Diagnosis
Differentiating a viral and a bacterial cause of a sore throat based on symptoms alone is difficult. Thus, a throat swab often is done to rule out a bacterial cause.The modified Centor criteria may be used to determine the management of people with pharyngitis. Based on five clinical criteria, it indicates the probability of a streptococcal infection.One point is given for each of the criteria:
Absence of a cough
Swollen and tender cervical lymph nodes
Temperature more than 38.0 °C (100.4 °F)
Tonsillar exudate or swelling
Age less than 15 (a point is subtracted if age is more than 44)The Infectious Disease Society of America recommends against empirical treatment and considers antibiotics only appropriate following positive testing. Testing is not needed in children under three, as both group A strep and rheumatic fever are rare, except if they have a sibling with the disease. Management
The majority of the time, treatment is symptomatic. Specific treatments are effective for bacterial, fungal, and herpes simplex infections.