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Sore throat is bothering, and it implies pharyngitis – Pharyngitis.

Pharyngitis is an infection or inflammation of the pharynx and tonsils. The specific treatment would depend on the cause.

The first step, what is pharyngitis?

Inflammation of the pharynx and tonsils is named pharyngitis and tonsillitis correspondingly. As in any inflammation, the possible causes include many harmful mechanisms being the most common in this case, an infection. Still, there are other plausible causes such as allergy, traumatic (ingesting boiling food or hazardous objects), toxins, or even cancer. We will review some of them further. Nevertheless, the main reason for this article is the most common cause, which I already told you, the infections.

What causes it?

Well, in pharyngitis, there are various potential microorganisms, such as bacteria, viruses, fungi, and parasites. Yet, the most prevalent by far are the bacteria and viruses. Similarly, the most common cause of acute pharyngitis is viral pharyngitis, followed by bacterial pharyngitis.

Viral pharyngitis can develop from a viral infection by at least 15 viruses. The viral throat infections are by rhinovirus, adenovirus, Epstein-Barr virus (infectious mononucleosis), herpes simplex (surprisingly yes, the same one that can affect you down in your genitals can affect you upwards), influenza virus (the flu), parainfluenza virus and coronavirus. Rhinovirus alone causes one-fifth of all the infectious pharyngitis cases. Its transmission is mostly through airborne and touching contaminated surfaces. Other viruses, causes pharyngitis but as a minor component of their diseases such as pharyngoconjunctival fever by the adenovirus, or mononucleosis disease by the Epstein-Barr virus.

It is interesting, and you are going to see why later in this article, that bacterial pharyngitis is mainly by just one microorganism, the Streptococcus pyogenes group A (GAS). The infection by this bacteria is known as strep pharyngitis or GAS pharyngitis, and given its possible complications, the identification is a must.

The streptococcal pharyngitis on its very-own causes 20% of all acute pharyngitis, leaving a narrow space for other bacteria such as Mycoplasma pneumoniae and Fusobacterium necrophorum. Indeed, bacterial infection by ten other bacteria could cause pharyngitis, but it is so odd that it is beyond the scope of this article. The same happens with the fungi and parasite microorganisms, which rarely occur and mainly affect people with a weakened immune system.

Is this infection a sexually transmitted disease?

This answer is tricky because it is yes and no at the same time, please allow me to explain better. It would depend on the microorganism and the way of contagion.

Non-sexual ways cause most of the viruses transmissions; therefore, in those cases, it is not a sexually transmitted disease (STD). But, some of them can have transmission by sexual contacts such as herpes simplex virus, cytomegalovirus, human immunodeficiency virus (HIV), and human papillomavirus (HPV).

For bacteria happens the same; oral sex connection to the development of bacterial infections in the throat is not a secret. The bacteria are Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum (which can cause secondary syphilis). All these infections are considered STDs.

It depends on the microorganism, but some of those infections can represent a real threat to life later on. Therefore, taking the right measures before engaging in a sexual relationship, or using male or female sexual protection is a must.

So the answer would be that not always pharyngitis is an STD, but can certainly be one if you don’t protect.

Is sore throat the only symptom in the infection?

No, sore throat wouldn’t be the only symptom. There’re a lot of other symptoms related to the infection, depending on the microorganism.

The viral infection is prone to cause a runny nose, cough, nasal congestion, sore throat, and fever. Nevertheless, not all of the symptoms are present all the time, such as the fever, which is usually mild. These symptoms are, in a nutshell, keener to be on the nose. The nose can even discharge mucus, which is initially clear and then greener.

On the contrary, streptococcal pharyngitis has symptoms that could be more severe. Firstly, because bacteria, in general, can produce pus. Therefore, in this case, the location of the pus could be either locally or nearby as a peritonsillar abscess.

Furthermore, streptococcal pharyngitis symptoms are widespread in the whole body. The symptoms include the sudden onset of sore throat, painful swallowing, chills, severe fever rising more than 105 °F, headache, nausea, vomiting, and abdominal pain. As I said earlier in this article, strep related infections have much more widespread and severe symptoms than viral infections.

In acute streptococcal pharyngitis, besides its sudden symptom onset, there are particular features visible a plain sight that can help to identify the infection. Your doctor would likely find the following during your thorough physical examination, such as swollen glands and swollen lymph nodes. Significantly, these lymph nodes are located in the front portion of the throat. Moreover, when the throat is examined in the inside, it is common to see in the tonsil minimal pus lesions. For that, the name, exudative pharyngitis, for the streptococcal infection.

You may want to see: Common Cold

What is the viral pharyngitis most similar to streptococcal pharyngitis?

Mononucleosis disease caused by the Epstein-Barr virus is a relatively common microorganism, and when it appears, the symptoms are similar to the ones of the bacterial infections; therefore, it is a problem for further diagnosis and treatment. The likewise symptoms are fever, sore throat, malaise, nausea but without vomiting, and chills.

Furthermore, many of the features found by your medical doctor in the physical exam of the patient with streptococcal pharyngitis are also found in patients with this virus, such as swollen lymph nodes, But, there are characteristics of this viral infection that makes it unique. As an increase in the size of the liver and spleen, also there could be some tenderness while touching the latter.

While it is typical of the bacterium, in this case, streptococcus, to have the presence of exudative pharyngitis, the viral organisms cause non-exudative pharyngitis. What is most confusing for the mononucleosis infection is that it can cause both of them. So, when the Epstein-Barr virus causes exudative pharyngitis, it can be confused with streptococcal pharyngitis.

Moreover, 30% of patients with mononucleosis can also have streptococcus within their throat. So it is likely that a patient undergoing a microbiological test could mistakenly get a streptococcal pharyngitis diagnosis. When the mononucleosis causes nonexudative pharyngitis, the diagnosis is easy, given the resemblance to the typical affection by the viral organisms.

How is pharyngitis diagnosed and treated?

Typically antibiotic prescription follows a scheme in regards to the severity of the symptoms, clinical and laboratory findings.

If the patient has mild and local symptoms, the assessment would be through a throat culture. In this procedure, a throat swab is used to take a sample of your pharynx for culturing it in a microbiological growth medium. If it happens to be positive, it is a bacterial pharyngitis diagnosis. Then, the patient could receive antibiotic therapy. However, if negative, the patient would receive symptom-relief treatment (acetaminophen, antiallergics, and so on).

When the symptoms are moderate or severe, a rapid streptococcal test utilization is a must. It is for a rapidly discard of the presence or not of bacterial pharyngitis. If it is positive, immediately, the patients start receiving antibiotic therapy. If not, then again, a throat culture exam takes place. Ultimately, any positive response would lead to antibiotic treatment.

Other exams are available for your doctor to use, such as anti-streptolysin O serum titers that, if positive, could also lead to antibiotic treatment. As you can observe, the aim of your physician will always be to find a bacterial infection that can benefit from antibiotics. No viral pharyngitis should receive antibiotics. It would only lead to more harm by eliminating the good bacteria in your body. These good bacteria reside within your throat and other body’s places participating in healthy processes.

Which antibiotic is best for pharyngitis?

Firstly, I should say that there aren’t specific antivirals for most of the viruses causing pharyngitis infection. Also, the use of antibiotics isn’t an indication of viruses, only bacteria.

The symptoms of streptococcal pharyngitis could disappear in three to four days without treatment, but antibiotics reduce the likelihood of complications. Treatment should last ten days, but a similar effect with lesser days has also been noted. Both oral penicillin V and amoxicillin are equally effective and first-line therapy for the infection.

What are the complications of this condition?

The importance of an early and accurate streptococcal pharyngitis diagnose is that if it doesn’t receive treatment, there is a possibility for future complications. Complications have a division in suppurative and non-suppurative. This division means that some complications involve pus and others not, correspondingly.

Suppurative or local complications result from streptococcal pharyngitis without treatment that spreads to nearby structures. Some of them are retropharyngeal abscess, peritonsillar abscess, sinusitis, otitis media, and mastoiditis.

From the non-suppurative complications, there are acute rheumatic fever, rheumatic heart disease, and post-streptococcal glomerulonephritis. Receiving antibiotics is in association with a decrease in all these conditions. They usually develop between two or four weeks after the infection and strongly impact the patient in the short or long term.

Is pharyngitis a cancer?

Pharyngitis is an inflammation, mostly by a viral infection, but it isn’t cancer. However, some of the symptoms in a pharyngitis infection could also be in throat cancer (oropharyngeal cancer). The people with throat cancer can experience sore throat, but typically the symptom here would present differently than in acute pharyngitis. It is a mild sore throat without any other particular symptom that has a long time and doesn’t go away. On the contrary, acute pharyngitis presents with bothering symptoms that make the patient seek help prematurely.

If you are feeling any of these symptoms you should consult your doctor or dentist because of their association with oral or throat cancer: changes in your voice, trouble opening your mouth, a cough that doesn’t go away, difficulty chewing or swallowing, and any changes in your lips as color, pain or function.

There are patient’s conditions that could tell even more than the symptoms itself about this cancer. The people over 65 years, and mostly male can develop this cancer. Also, the behavior influences the outcome. The people that have more than four drinks per day and smoke tobacco significantly increase their chances of getting throat cancer.

When you should contact your healthcare provider?

The symptoms will guide you if you are experiencing moderate to severe symptoms in the throat, such as pain swallowing and sore throat. Then it would be great to get help from your healthcare provider. Mostly, if you have a high fever, and body aches.

Minor symptoms which are mostly in the nose, like sneezing and stuffy nose aren’t a reason for seeking medical assistance.

Do you want to know If you have this infection?

There is no need to worry. This pharyngitis symptoms checker would aid you in determining how likely it is that you have this disease! It is free and would only take a few minutes.

What do you think?

Written by Dr. Esteban Kosak

Doctor of Medicine - MD Recently Graduated from Medical School and inspired to aid the global population during this situation. I think that we shall no longer be waiting to see a doctor when we feel sick. Several times we feel disease searches in Google drive us to a rabbit hole and come out thinking that we may die of cancer or something very serious, given that symptoms may seem to fit a wide variety of illnesses. Since I recently graduated from medical school. I have all the medical information fresh in my mind. My thorough experience as an expert researcher allows me to very-well known the different diseases and conditions that affect human bodies. Empowered by the United Nations 17 Sustainable Development Goals (SGDs). I think that we all can provide a grain of sand to help humanity. That's why we created Symptoms.Care a place where you can come and screen your symptoms and find what different illnesses can be related to them. Armed with the right information you can instantly, discretely, secure and from the comfort of your home talk with a Doctor that can Evaluate your Symptoms and help you seek the right treatment.


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