-
Infectious Disease Clinics of North... Jun 2007Acute pharyngitis is one of the most common illnesses for which patients visit primary care physicians. Most cases are of viral origin, and with few exceptions these... (Review)
Review
Acute pharyngitis is one of the most common illnesses for which patients visit primary care physicians. Most cases are of viral origin, and with few exceptions these illnesses are both benign and self-limited. The most important bacterial cause is the beta-hemolytic group A streptococcus. There are other uncommon or rare types of pharyngitis. For some of these treatment is required or available, and some may be life threatening. Among those discussed in this article are diphtheria, gonorrhea, HIV infection, peritonsillar abscess, and epiglottitis.
Topics: Epiglottitis; Humans; Pharyngitis
PubMed: 17561078
DOI: 10.1016/j.idc.2007.03.001 -
Immunity, Inflammation and Disease Dec 2022
Topics: Humans; Pharyngitis; Anti-Inflammatory Agents
PubMed: 36444626
DOI: 10.1002/iid3.738 -
Primary Care Dec 1996This article reviews the commonly encountered agents causing acute inflammation of the pharynx and tonsils, with special attention to a practical approach for... (Review)
Review
This article reviews the commonly encountered agents causing acute inflammation of the pharynx and tonsils, with special attention to a practical approach for identifying and dealing with the group A beta-hemolytic streptococcus. Ubiquitous viral agents such as Epstein-Barr virus, rhinovirus, and adenovirus are reviewed. Some agents such as group A beta-hemolytic streptococcus and Epstein-Barr virus are susceptible to treatment. Additionally, unusual infectious agents and noninfectious causes of pharyngitis are enumerated.
Topics: Adolescent; Age Distribution; Algorithms; Anti-Bacterial Agents; Child; Child, Preschool; Decision Trees; Diagnosis, Differential; Humans; Infant; Pharyngitis
PubMed: 8890141
DOI: 10.1016/s0095-4543(05)70359-6 -
The New England Journal of Medicine Mar 2019
Topics: Child; Female; Fever; Humans; Pharyngitis; Pharynx; Streptococcal Infections; Streptococcus pyogenes
PubMed: 30855746
DOI: 10.1056/NEJMicm1810556 -
PLoS Neglected Tropical Diseases Mar 2018Antibiotic treatment of Group A Streptococcus (GAS) pharyngitis is important in acute rheumatic fever (ARF) prevention, however clinical guidelines for prescription... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Antibiotic treatment of Group A Streptococcus (GAS) pharyngitis is important in acute rheumatic fever (ARF) prevention, however clinical guidelines for prescription vary. GAS carriers with acute viral infections may receive antibiotics unnecessarily. This review assessed the prevalence of GAS pharyngitis and carriage in different settings.
METHODS
A random-effects meta-analysis was performed. Prevalence estimates for GAS+ve pharyngitis, serologically-confirmed GAS pharyngitis and asymptomatic pharyngeal carriage were generated. Findings were stratified by age group, recruitment method and country income level. Medline and EMBASE databases were searched for relevant literature published between 1 January 1946 and 7 April 2017. Studies reporting prevalence data on GAS+ve or serologically-confirmed GAS pharyngitis that stated participants exhibited symptoms of pharyngitis or upper respiratory tract infection (URTI) were included. Included studies reporting the prevalence of asymptomatic GAS carriage needed to state participants were asymptomatic.
RESULTS
285 eligible studies were identified. The prevalence of GAS+ve pharyngitis was 24.1% (95% CI: 22.6-25.6%) in clinical settings (which used 'passive recruitment' methods), but less in sore throat management programmes (which used 'active recruitment', 10.0%, 8.1-12.4%). GAS+ve pharyngitis was more prevalent in high-income countries (24.3%, 22.6-26.1%) compared with low/middle-income countries (17.6%, 14.9-20.7%). In clinical settings, approximately 10% of children swabbed with a sore throat have serologically-confirmed GAS pharyngitis, but this increases to around 50-60% when the child is GAS culture-positive. The prevalence of serologically-confirmed GAS pharyngitis was 10.3% (6.6-15.7%) in children from high-income countries and their asymptomatic GAS carriage prevalence was 10.5% (8.4-12.9%). A lower carriage prevalence was detected in children from low/middle income countries (5.9%, 4.3-8.1%).
CONCLUSIONS
In active sore throat management programmes, if the prevalence of GAS detection approaches the asymptomatic carriage rate (around 6-11%), there may be little benefit from antibiotic treatment as the majority of culture-positive patients are likely carriers.
Topics: Anti-Bacterial Agents; Carrier State; Developed Countries; Developing Countries; Humans; Pharyngitis; Practice Guidelines as Topic; Rheumatic Fever; Streptococcal Infections; Streptococcus pyogenes
PubMed: 29554121
DOI: 10.1371/journal.pntd.0006335 -
American Family Physician Jul 2016Group A beta-hemolytic streptococcal (GABHS) infection causes 15% to 30% of sore throats in children and 5% to 15% in adults, and is more common in the late winter and... (Review)
Review
Group A beta-hemolytic streptococcal (GABHS) infection causes 15% to 30% of sore throats in children and 5% to 15% in adults, and is more common in the late winter and early spring. The strongest independent predictors of GABHS pharyngitis are patient age of five to 15 years, absence of cough, tender anterior cervical adenopathy, tonsillar exudates, and fever. To diagnose GABHS pharyngitis, a rapid antigen detection test should be ordered in patients with a modified Centor or FeverPAIN score of 2 or 3. First-line treatment for GABHS pharyngitis includes a 10-day course of penicillin or amoxicillin. Patients allergic to penicillin can be treated with firstgeneration cephalosporins, clindamycin, or macrolide antibiotics. Nonsteroidal anti-inflammatory drugs are more effective than acetaminophen and placebo for treatment of fever and pain associated with GABHS pharyngitis; medicated throat lozenges used every two hours are also effective. Corticosteroids provide only a small reduction in the duration of symptoms and should not be used routinely.
Topics: Amoxicillin; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Antigens, Bacterial; Exudates and Transudates; Fever; Humans; Lymphadenopathy; Neck; Pain Management; Penicillins; Pharyngitis; Streptococcal Infections; Streptococcus pyogenes
PubMed: 27386721
DOI: No ID Found -
The New England Journal of Medicine May 2017
Topics: Exanthema; Humans; Male; Pharyngitis; Pharynx; Scarlet Fever; Streptococcus pyogenes; Young Adult
PubMed: 28514617
DOI: 10.1056/NEJMicm1612308 -
MMW Fortschritte Der Medizin Jan 2023
Topics: Humans; COVID-19; Cough; Pharyngitis; Rhinorrhea
PubMed: 36648683
DOI: 10.1007/s15006-023-2272-x -
The Journal of Allergy and Clinical... Jun 2023Children and adults with autoinflammatory disorders, who often experience recurrent fevers, rashes, cold-induced symptoms, conjunctivitis, lymphadenopathy, recurrent...
Children and adults with autoinflammatory disorders, who often experience recurrent fevers, rashes, cold-induced symptoms, conjunctivitis, lymphadenopathy, recurrent infections, aphthous stomatitis, and abnormal blood cell counts, may present to the allergist/immunologist because the symptoms mimic allergies and disorders of immunity. In recent years, there has been increased recognition of non-monogenic autoinflammatory disorders, including periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome and syndrome of undifferentiated recurrent fevers. For many clinical practitioners, the natural history, diagnostic criteria, differential diagnoses, and preferred therapies remain challenging because of the presumed rarity of patients and the evolving field of autoinflammation. Here, we aim to provide a practical framework for the clinical allergist/immunologist to evaluate and treat this patient population.
Topics: Humans; Child; Adult; Stomatitis, Aphthous; Lymphadenitis; Pharyngitis; Fever; Lymphadenopathy; Nasopharyngitis; Syndrome
PubMed: 36958521
DOI: 10.1016/j.jaip.2023.03.014 -
Periodontology 2000 Feb 2009
Review
Topics: Adolescent; Anti-Bacterial Agents; Child; Child, Preschool; Humans; Pharyngitis; Streptococcal Infections; Streptococcus; Tonsillitis; Virulence Factors
PubMed: 19152531
DOI: 10.1111/j.1600-0757.2008.00282.x