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Acute pharyngitis


Acute pharyngitis Acute pharyngitis is inflammation of the pharyngeal mucosa, accompanied by discomfort, sore throat and sore throat. According to medical statistics, the diagnosis of "acute pharyngitis" is made annually by 9% of patients who see a doctor because of a sore throat. The disease is especially common in children and adolescents. In people over 45, acute pharyngitis is rare.

Causes of acute pharyngitis

Acute pharyngitis can develop as a result of various factors:

  • viruses;
  • bacteria;
  • hypothermia or burn mucous:
  • injury - foreign body hit, surgical or other medical intervention;
  • reduced immunity;
  • irritation by mucous alkali, acid, dust, toxic substances, allergens.

Alcohol abuse, smoking also in some cases cause acute pharyngitis.
According to the etiological factor, the following types of acute pharyngitis are distinguished:

  • viral;
  • fungal;
  • bacterial;
  • traumatic;
  • allergic;
  • caused by irritants - acids, alkalis, hot liquids, radiation, etc.

Inflammation usually covers all departments of the pharynx.

Viral pharyngitis

Catarrhal pharyngitis resulting from ARVI is the most common form of the disease. The cause of almost 70% of the occurrence of acute pharyngitis are viruses:

  • rhinoviruses;
  • flu viruses, parainfluenza;
  • coronaviruses;
  • rhinoviruses;
  • adenovirus;
  • AIDS virus;
  • herpes simplex virus;
  • Coxsackie virus;
  • enteroviruses;
  • cytomegalovirus ;
  • Epstein-Barr virus;
  • respiratory syncytial virus.

Moreover, in more than 80% of cases, it is rhinoviruses that are responsible for ARVI epidemics during the off-season periods. And their value continues to grow rapidly.

More often, viral infection only “paves the way”, creates conditions for subsequent bacterial infections, being only the first phase of acute pharyngitis.

Fungal strep throat

In the general structure of lesions by fungi of the upper respiratory tract, mycotic lesions occupy the second place. In 93% of the cases, Candida fungi are the causative agent. The cause of pharyngomycosis may be the following representatives of this genus of yeast-like fungi:

  • albicans;
  • guilliermondii;
  • stellatoidea;
  • pseadotropicalis;
  • parapsilosis;
  • brumptii;
  • tropicalis;
  • intermedia and others

In half of all cases of acute fungal pharyngitis, Candida albicans is found. The course of the disease depends on the general condition of the body.

Candida acute pharyngitis

Candidiasis of tonsils begins with tickling, discomfort, insignificant pain in the throat. There may be a slight fever, malaise, feeling of weakness.

More common bilateral lesion of the tonsils. Moreover, their mucous membranes are only slightly hyperemic, but there is always a white or gray patina - tiny, porous, curd. The plaque is usually easily removed, exposing the slightly hyperemic smooth mucous membrane of the tonsils.

The raids can spread beyond the tonsil tissues: on the mucous membrane of the cheeks, the soft palate, the back wall, the roots of the tongue, the bow.

In some cases, the plaque may be dense and when it is removed, weakly bleeding and eroded tonsil mucosa is exposed.

Candida tonsils can cause periodic exacerbations, the cause of which is the activity of the fungus-pathogen. The course of the disease is usually protracted.

Throat mold mycoses

Throat mold mycoses are less common. Moreover, the clinical picture differs from candida by the severity of local symptoms and the nature of pathological raids.

For example, with aspergillosis:

  • unilateral inflammatory process;
  • severe sore throat may radiate to the ear;
  • the amygdala is enlarged and hyperemic;
  • the color of the raids is yellowish or whitish;
  • the plaque covers only the amygdala, the anterior arch.

Plaque is difficult to remove, and the erosive surface of the mucous membrane is exposed. Lymph nodes are enlarged.

Bacterial pharyngitis

Two forms of acute pharyngitis are distinguished:

  • catarrhal - characterized by pain in the pharynx, moderate deterioration of the general condition, a slight increase in temperature, often viral etiology;
  • purulent - significant deterioration of the general condition, temperature rise up to 38 0 С, bacterial etiology dominates.

Bacterial acute pharyngitis accounts for about 15% of all pharyngitis. Most often, they are caused by group A streptococcus. In addition, the following microorganisms can be the cause of acute bacterial pharyngitis:

  • Group C beta-hemolytic streptococcus;
  • Haemophilis influenzae (epiglottitis);
  • Group G beta-hemolytic streptococcus;
  • Yersinia enterocolitica;
  • Anaerobes (Peptostreptococcus, Fusobacterium, and Bacteroides spp.);
  • Franciseeea tularensis (tularemia);
  • Arcanobacterium haemolyticum;
  • Neisseria gonorrhoeae;
  • Chlamydia pneinnoniae;
  • Mycoplasma pneumoniae;
  • Corynebacterium haemolyticum;
  • Corynebacterium diphtheria.

For streptococcal acute pharyngitis is characterized by a sudden onset:

  • soreness and an increase in regional lymph nodes;
  • severe pain in the nasopharynx;
  • temperature rise up to 38 0 С;
  • chills.

The surface of the lymphoid follicles may be covered with white purulent deposits.

How is acute pharyngitis?

The morphology of acute pharyngitis is expressed by edema and infiltration of mucosal cells. At the same time, desquamation (desquamation) of epithelium cells, expansion and injection of blood vessels are observed. The most complete inflammation is expressed on the side and back of the pharynx, near the mouths of the auditory tubes, in the arch of the nasopharynx.

With catarrhal forms of the disease are observed:

  • persistent venous hyperemia;
  • perivascular cell infiltration;
  • "Pasty" mucous.

Hypertrophic forms are characterized by the density of a thickened mucous membrane, the expansion of lymphatic and blood vessels. Inflammation may be localized on the lateral parts of the pharynx or on its back wall.

For atrophic pharyngitis, the “varnished” dry surface of the thinned mucous membrane is characteristic.

Common symptoms of acute pharyngitis

Acute inflammations of the pharyngeal mucosa rarely occur in isolation. More often they develop with various infections of the upper respiratory tract. Only in the case of exposure to stimuli directly on the surface of the mucous membrane can be observed isolated acute pharyngitis:

  • hot or cold food;
  • mechanical damage to the mucous membrane;
  • breath through the mouth - contact with the mucous membrane of cold air, dust, etc .;
  • smoking;
  • alcohol consumption.

In acute pharyngitis, the following symptoms are observed:

  • soreness, sore throat;
  • insignificant pain when swallowing - the pain is aggravated by “empty throat”;
  • irradiation of pain in the ears is possible.

The general condition of the patient depends on the etiology of inflammation, the state of the human immune system.

The disease can be independent or be part of another disease - measles, scarlet fever, influenza, ARVI. In these cases, the symptoms of acute pharyngitis are complemented by symptoms of the underlying disease.

Clinical manifestations of acute pharyngitis

Acute pharyngitis - acute inflammation of the posterior pharyngeal wall, may have different manifestations:

  • hypertrophic (granular);
  • subatrophic.

The first are more common in children, adolescents, young people. Hypertrophic inflammation occurs rapidly and is characterized by the formation of a large number of large and medium-sized granulations on the back of the pharynx. The patient is worried about pain, feeling in the throat of a foreign body. It hurts to swallow, and the “empty mouthful” is more painful than swallowing food. Body temperature can rise to 37.5 0 C.

The flow of subatrophic pharyngitis is sluggish, prolonged without temperature increase. The patient complains of tickling and dryness in the pharynx, dry cough, pain when swallowing. The mucosa of the posterior pharyngeal wall is dry, thinned, with fine granulations, vascular injection may be observed. Subatrophic acute pharyngitis is usually observed in middle-aged and older individuals:

  • smokers;
  • workers in hazardous industries - aggressive chemicals, various thermal factors, dust, etc .;
  • persons who have tonsillectomy;
  • Persons of "speech" professions - speakers, teachers, dispatchers and others.

In recent years, subatrophic acute pharyngitis "younger" - found in young people.

Diagnosis of acute pharyngitis

The diagnosis of acute pharyngitis is made on the basis of the collected history and pharyngoscopy. To determine the nature of the causative agent of inflammation, bacteriological and virological studies of pharyngeal swabs are conducted.

Treatment of acute pharyngitis

The treatment regimen is prescribed by an otolaryngologist. Usually, factors that cause inflammation are excluded first. The patient is recommended to refrain from any products, actions that can irritate the pharyngeal mucosa:

  • salty, spicy, cold, hot, sour food;
  • alcohol;
  • smoking.

Local treatment is also prescribed - frequent rinsing with antiseptic solutions, inhalations, aerosol anti-inflammatory drugs. The medicinal complex may include folk remedies - herbal teas, juice of various plants.

In case of bacterial pharyngitis, antibiotic therapy is carried out. Cauterization of granules with silver nitrate solution, trichloroacetic acid is prescribed for hypertrophic pharyngitis. The methods of cryotherapy, radio wave and laser effects can also be used.

Complications of the disease

The course of acute pharyngitis can be quite dangerous in young children - the risk of suffocation due to swelling of the throat.

Another serious complication of acute pharyngitis is the development of an abscess. Abscesses can form around the tonsils, under the back of the throat, in the thickness of the neck tissue. The presence of an abscess is indicated by an elevated temperature that persists even in the case of external signs of recovery. Purulent abscesses are treated only by surgical methods.

The most dangerous complications of acute pharyngitis are the development of autoimmune reactions resulting from an increase in the body's sensitivity to microorganisms that caused inflammation of the pharynx mucosa. Autoimmune (allergic) complications can cause rheumatism of the joints, damage to the kidneys, brain, heart valves.

Possible transition of acute pharyngitis in the chronic form.

Prevention of acute pharyngitis

Any disease is easier to prevent than to treat, acute pharyngitis is no exception.

First, the possibility of exposure to the pharyngeal mucosa of various irritants should be eliminated.

  • Food should be warm, well-chewed.
  • Avoid spicy, salty, acidic foods, carbonated drinks.
  • Avoid mechanical damage to the mucous membrane - bones of fish, meat, crackers. If necessary, medical or surgical intervention that can damage the surface of the mucous to take the necessary measures to prevent the development of inflammation - treatment of abrasions, wounds.
  • Do not smoke.
  • Do not drink alcohol (including beer).
  • Do not breathe air through the mouth.

The general and local hardening, timely treatment of diseases of the nasopharynx, nose, nasal sinuses will help reduce the risk of developing viral and bacteriological acute pharyngitis. Sanitation of the oral cavity is also of great importance.

Prevention and treatment of common diseases of other body systems - the gastrointestinal tract, cardiovascular, respiratory and others, will also help prevent acute pharyngitis. The development of inflammatory processes in the pharyngeal mucosa is associated with metabolic disorders in the immune system.

You must follow the rules of personal hygiene, general sanitary rules - washing hands, wet cleaning.

| 5 December 2014 | | 3,934 | ENT diseases