1. PHARYNGITIS
It is the inflammation of the pharynx which is the back of the throat. It is also
referred to as “Sore throat”. It is a type of upper respiratory tract infection. It is one
of the most common reason to doctorvisit.
CLASSIFICATION
It is of 2 types: Acute Pharyngitis and chronic Pharyngitis.
ACUTE PHARYNGITIS
It is a sudden, painful inflammation of the throat.
ETIOLOGY
1. Virus: Most common cause (90%) of sore throat. Adenovirus, coronavirus,
Homophiles influenza, Mononucleosis. They do not respond to antibiotic
therapy.
2. Bacterial: Less common cause of sore throat. Strep throat is a common
bacterial infection of pharynx caused by Group A beta hemolytic
streptococci(GAS). Other bacteria are mycoplasma Pneumoniae, Neisseria
meningitis etc.
RISK FACTORS
1. Frequent exposure to cold and flu.
2. Allergies
3. Frequent sinusitis
4. GERD
5. Exposure to secondhand smoke.
PATHOPHYSIOLOGY
2. CLINICAL MENIFESTATIONS
1. Fiery red pharyngeal membrane and tonsils.
2. Fever(101 F)
3. Malaise
4. Sore throat pain ( In case of GAS bacteria)
5. Swollen , erythomatous tonsils
6. Halitosis.
DIAGNOSTIC EVALUATION
1. History taking
2. Physical examination
3. CBC
4. Throat swab culture.
5. Rapid streptococcalantigen test.
MEDICAL MANAGEMENT
Uncomplicated viral Pharyngitis infections subside promptly within 3 to 10
days after onset. Viral Pharyngitis is treated with supportive measures because
antibiotics have no effects on the causative agents.
A. PHARMACOLOGICAL THERAPY: In case of bacterial
Pharyngitis Penicillin is the treatment of choice and given for 5 days. Patient
who are allergic to penicillin and erythromycin, they are treated with
Cephalosporin and macrolides. Severe sore throat can be relieved by
analgesics such as Aspirin, Acetaminophen. If required acetaminophen with
codeine can be taken three to four times daily. Some patients find slat-water
gargling to be soothing. In severe cases, Gargles with benzocaine may
relieve symptoms.
B. Nutritional therapy: A liquid or soft diet is provided during the acute
stage of the disease. Sometimes throat is so sore that liquid can not be taken
in adequate amount. In severe situations IV fluids may be needed. Otherwise
patient is encouraged to drink as much fluid as possible.
4. CHRONIC PHARYNGITIS
Chronic Pharyngitis is a persistent inflammation of the pharynx. It is
common in the adults who work in dusty surroundings, use their voice to
excess, suffer from chronic cough or habitually use alcohol and tobacco.
CLASSIFICATION
1. Hypertrophic: It is characterized by thickening and congestion of the
pharyngeal mucous membrane.
2. Atrophic: Late stage . The membrane is thin, whitish, glistening.
3. Chronic granular: Numerous swollen lymph nodes on the pharyngeal
wall.
CLINICAL MENIFESTATIONS
1. Sense of irritation and fullness in the throat.
2. Mucus buildup which is expelled out by coughing.
3. Nasal congestion
4. Dysphagia.
MANAGEMENT
Nasal congestion is relieved by short term use of nasal sprays or
medications containing ephedrine sulphate.
For a patient with a history of allergy , antihistamine decongestants
such as Pseudoephedrine is prescribed orally every 4 -6 hours.
Aspirin or acetaminophen is recommended .
For adults with chronic Pharyngitis, tonsillectomy is an effective
option.
NURSING MANAGEMNT
To prevent the infection from spreading, the nurse instructs the
patient to avoid contactwith others until the fever subsides.
The nurse recommends avoidance of alcohol, tobacco,
secondhand smoke, and exposure to cold environment and
occupational pollutants.
The nurse encourage the patient to have plenty of drink or fluids.
5. Gargling with warm saline solution may relieve throat discomfort
. Lozenges keep the throat moistened.
