Sore throat is one of the most common conditions in cold times. Irritation, inflammation and tenderness in the upper throat (pharynx) takes many people – adults and children – to hospitals and health centers.
Viral or bacterial in origin, there are several precautions that can hinder the manifestation of this discomfort. Read more!
Contents
What is pharyngitis?
Pharyngitis is an inflammation of the pharynx, an organ that sits in our throat. It makes the connection between the nose and the mouth and also connects the larynx to the esophagus. When the pharynx is inflamed, the person feels irritation, pain, itching, discomfort in the region, among other signs.
Inflammation in the pharynx usually occurs in winter, when the air is drier and the population tends to concentrate indoors, with little or no ventilation.
In this way, bacteria and viruses enter the airways more easily and cause disease. Other typical conditions of the season are laryngitis and tonsillitis .
What is bacterial pharyngitis?
With 15% of infections in adults and 30% in children, bacterial pharyngitis is rarer and more dangerous than viral. It is caused by bacteria that contaminates the pharynx. This type of pharyngitis can cause a high fever and may require the use of antibiotics.
Most common type of pharyngitis, representing approximately 70% of cases with children and 85% of cases with adults, viral pharyngitis is caused, as the name says, by a virus that contaminates the pharynx.
It is usually accompanied by the disease that the virus causes, such as the flu, for example. Its symptoms are milder compared to the other type of the disease.
Pharyngitis, laryngitis or tonsillitis?
These three diseases are often confused as they have extremely similar symptoms. All three cause a sore throat and are caused by both viruses and bacteria. They are all inflammations, but in different places.
The treatments, although similar, have important differences. For example, laryngitis requires rest of the voice, pharyngitis can be treated with lozenges and tonsillitis may need surgery to remove the tonsils.
Pharyngitis
Pharyngitis happens in the pharynx . It is the part of the throat that we can see deep in the mouth when we open it and look in the mirror. It connects the mouth to the two channels of the throat, the esophagus (which leads to the stomach) and the larynx, which leads to the trachea and lungs.
Laryngitis
Laryngitis affects the larynx . It is at the top of the trachea and is where the vocal cords are located. You can’t see the larynx just by opening your mouth.
Tonsillitis
Tonsillitis affects the tonsils, also called palatine tonsils . It is the part of the body that connects the mouth to the pharynx. You can see your tonsils, which are two, in the mirror.
To do this, open your mouth and tighten the back of your throat, as if closing the path. Deep down, the tonsils will appear. Without contraction, they are hidden behind the walls of your mouth.
What types?
Pharyngitis can be divided into three types. Are they:
Viral pharyngitis
Most common type of pharyngitis, representing approximately 70% of cases with children and 85% of cases with adults, viral pharyngitis is caused, as the name says, by a virus that contaminates the pharynx.
It is usually accompanied by the disease that the virus causes, such as the flu , for example. Its symptoms are milder compared to the other type of the disease.
Bacterial pharyngitis
With 15% of infections in adults and 30% in children, bacterial pharyngitis is rarer and more dangerous than viral. It is caused by bacteria that contaminates the pharynx. This type of pharyngitis can cause a high fever and may require the use of antibiotics .
Non-infectious or allergic pharyngitis
This type of pharyngitis is not caused by viruses or bacteria, but by irritation in the pharynx. People with rhinitis and who for some reason have a congested nose and are forced to breathe through their mouth may suffer from it.
The nose usually heats and filters the air, something that the mouth does not do. This untreated air reaches the pharynx, which loses heat and moisture to the air.
This can also happen to anyone in environments with a lot of air conditioning, pollution, or in times when the climate is very dry.
Read more: Components added to medicines can cause allergy
Acute, recurrent or chronic pharyngitis: what is the difference?
There are 3 pictures or types of manifestation of pharyngitis: acute, recurrent and chronic:
Sharp
Acute pharyngitis is characterized by the presence of fever, itchy nose, respiratory obstruction and wheezing when breathing.
In general, they are pictures with simple treatment, if the medical recommendations are followed. The symptoms disappear quickly after starting treatment.
Recurrent
Recurrent pharyngitis is characterized by 4 acute episodes or more in 6 months.
Chronicle
Chronic pharyngitis occurs when there is persistence and continuity of the condition. There may be constant nasal itching, halitosis, constant nasal discharge, difficulty breathing, chronic obstruction and congestion.
What are the causes of pharyngitis?
The main causes of pharyngitis can be reduced simply to viruses and bacteria. It is more common that the disease affects people in the winter, when one seeks to stay in more heated and closed places, which favors the transmission of infectious agents to the respiratory tract.
Dry air also facilitates throat irritation, which is conducive to both infections and non-infectious pharyngitis.
Virus
The viruses that most often cause pharyngitis are influenza (influenza virus), parainfluenza and adenovirus, but other viral infections, if they affect the pharynx, can cause inflammation. The following viruses are known to cause the disease:
- Orthomyxoviridae , family of the influenza virus;
- Adenovirus;
- Virus Epstein-Barr virus , which causes infectious mononucleosis;
- The Herpes simplex virus, which causes herpes;
- The Paramixovirus virus, which causes measles;
- Rhinovirus , Coronavirus and Parainfluenza , responsible for the cold;
- HIV, the virus da AIDS.
Bacteria
Bacterial pharyngitis is often caused by bacteria called streptococci. Most types of this bacteria are harmless, but some can lead to pharyngitis, meningitis and pneumonia .
When the bacterium that causes pharyngitis is group A beta-hemolytic streptococcus (EBGA), there are greater risks such as rheumatic fever.
In cases of bacterial pharyngitis, the patient must be observed to avoid progression of the disease and involvement of the respiratory tract.
It is also possible to acquire pharyngitis through the bacteria that cause gonorrhea and chlamydia.
What is streptococcal pharyngitis and what causes it?
Streptococcal pharyngitis is a bacterial type of infection. Although less common than viral, it tends to be more intense. The cause is infection with Streptococcus pyogenes or group A streptococcus, which is highly contagious and spreads easily through the air.
When a patient with this infection sneezes or coughs, the microorganism spreads through the air or settles on surfaces, such as door handles and supports for public transport.
By touching these items or inhaling contaminated air particles, the person is susceptible to contracting the infection.
Pharyngitis catches?
Depending on the type, yes! If it is bacterial or viral pharyngitis, it can be transmitted between people. But if it is allergic pharyngitis, the cause is genetic. So, it is the fault of the mites, fungi, dust or other irritating agents that cause allergic attacks capable of progressing to pharyngitis.
How does transmission occur?
With the crowding of people in closed environments, the chances of getting a disease in the airways increase, since the air is unable to circulate. If someone is infected, viruses will spread throughout the environment and contaminate everyone.
Pharyngitis can be contracted through speech, sneezing and coughing (which release droplets of saliva into the air), kissing, sharing cutlery, straws.
Also by any direct contact with someone who has the virus or bacteria that causes pharyngitis in your body can transmit the disease.
Oral sex is also a pathway for bacteria to the pharynx, as bacteria from venereal diseases such as gonorrhea and chlamydia can affect the throat.
Groups of risk
Situations with many people indoors and contact with infected people facilitate transmission, but there are groups that are even more likely to become infected. Are they:
Children and adolescents
Children and adolescents have a higher risk of contamination by bacteria that cause pharyngitis.
People with sexually transmitted diseases
Some STDs such as gonorrhea and chlamydia can be transmitted from the genital area to the throat, causing inflammation of the pharynx. This can happen either through oral sex or by contact of the hands with the genitals followed by contact with food or the mouth itself.
HIV- positive patients may also find it easier to acquire pharyngitis because of their weakened immune system.
Smokers
Smokers have an irritated pharynx, in addition, the heat from the burnt smoke dries out the pharynx. This facilitates contamination by viruses and bacteria, causing inflammation.
Passive smokers can also be affected by throat irritation.
Contact with chemical and / or toxic substances
Like smokers, frequent contact with chemicals can irritate the respiratory system, which facilitates infections.
Allergies
Having allergic reactions to dust, animals, mold, among others, can facilitate the contamination that causes pharyngitis.
Drinking very hot drinks and frequent alcohol
These activities also irritate the pharynx, facilitating the contamination of agents that cause pharyngitis.
Low immunity
Low immunity allows bacterial and viral contamination to settle in the body more easily.
What are the symptoms?
The symptoms of pharyngitis are easy to identify. Despite this, it is easily confused with laryngitis and tonsillitis, which also affect the throat and show similar symptoms. The main symptoms are these:
Viral pharyngitis
- Fever;
- Sore throat;
- Decreased appetite;
- Redness of the throat;
- Swollen neck;
- Discomfort when swallowing;
- Hoarseness.
Earaches, headaches and vomiting may also appear, although these are more rare symptoms. Fever related to viral pharyngitis is usually mild when compared to that caused by bacteria.
Bacterial pharyngitis
This version of the disease is more aggressive and its symptoms usually appear abruptly 2 to 5 days after the infection. The symptoms are as follows:
- Sore throat;
- Hoarseness;
- Redness in the throat with the presence of pus;
- Difficulty swallowing;
- Headache;
- Fever above 38 ºC;
- Nausea;
- Vomiting;
- Stomach ache;
- Loss of appetite;
- Languages.
Earaches can appear if the infection spreads and becomes otitis .
How is pharyngitis diagnosed?
The doctor who makes the diagnosis of pharyngitis is the general practitioner or the otorhinolaryngologist , who is the specialist doctor in the ear, nose and throat. He can order the following tests:
Examination of the oropharynx
During the examination of the oropharynx , the patient has the throat examined and the doctor can identify the inflammation.
This is where the diagnosis of pharyngitis is made.
However, through this exam, it is not possible to differentiate with certainty the viral pharyngitis from the bacterial one, which is an important step, since the treatment is different for each of the types.
Knowing the symptoms, the doctor can decide if there is a need for further examinations.
A patient with a high fever and pus in the throat has strong indications that the infection is bacterial, while one with a cough and runny nose indicates that there is a viral infection.
For this confirmation, laboratory tests are performed .
Rapid antigen test for EBGA
This test looks for antigens for the EBGA bacteria, the group A beta-hemolytic streptococcus, which is the bacteria that causes the most aggressive pharyngitis. It is an examination done in emergencies and has quick results.
Culture of oropharyngeal secretion
This exam also looks for EBGA bacteria through bacterial culture.
It has 90 to 99% sensitivity to bacteria, but it takes longer to get ready. Because of this, it is recommended for hospitalizations, not in emergencies.
Hemocultura
Bacterial culture of the patient’s blood, seeks to find bacteria in it.
It is also more recommended for hospitalizations than for emergencies, because of the time it takes for bacteria to develop and be found.
Culture of the oropharynx in search of gonococcus or chlamydia
If the patient’s history indicates the possibility of pharyngitis caused by gonorrhea or chlamydia, this test is indicated to obtain proof or refutation of the presence of these bacteria as the cause of pharyngitis.
Computed tomography of the soft tissues of the neck
If the doctor suspects abscesses or involvement of the deep neck spaces, this test can confirm or eliminate the suspicion.
Beginning of treatment
If there are no signs of bacterial infection, further tests are not necessary and treatment for viral pharyngitis can begin.
Depending on the amount of symptoms that indicate the bacterial presence, it is possible to start treatment for this type of pharyngitis while waiting for the laboratory results.
Does pharyngitis have a cure?
Yes, pharyngitis is curable and it is usually quick. With proper treatment, the symptoms of bacterial pharyngitis can disappear within a week. Viral pharyngitis usually resolves on its own and medications are used to reduce symptoms.
What is the treatment?
Each type of pharyngitis has a type of treatment, but in both cases, it is usually easy.
Viral pharyngitis
In the case of viral pharyngitis, rest and hydration are enough to cure the disease. The body itself is capable of dealing with the infection and, after a few days, it disappears.
However, it is possible that the doctor prescribes anti-inflammatories and painkillers to treat the patient’s symptoms and discomfort.
Bacterial pharyngitis
When there is bacterial pharyngitis, it is necessary to use antibiotics that can be administered orally, a treatment that usually lasts from 7 to 10 days, and by intramuscular injection, of a single dosage. In this case, the injected antibiotic is benzathine penicillin G.
In case of allergy to penicillin, there are other antibiotics that can be used orally.
Remember: do not stop your antibiotic treatment before your doctor tells you to, even if the inflammation is gone.
Antibiotics kill bacteria and, when they are few, the inflammation goes away, but that does not mean that they are no longer there.
It is necessary to continue taking the antibiotic to ensure that all bacteria are eliminated.
If you stop the treatment before it happens, they will reproduce again, the inflammation will return, and there are great chances that it will develop resistance to the antibiotic, becoming a superbug .
Internment
In some cases of more severe bacterial infection, the patient may have to be admitted.
Hospitalization is recommended for severe cases in which there is difficulty in swallowing that may lead to the risk of dehydration.
That is, if the patient is unable to swallow or liquids, or if there is a risk of compromising the airways, such as a tumor in the throat.
Superbacteria
Superbacteria are bacteria that have developed resistance to most antibiotics.
This happens because of the misuse of this type of medication, stopping the use as soon as the symptoms disappear or taking antibiotics for anything.
This behavior exposes the bacteria to the antibiotic without the ability to eliminate all of them and those that survive end up developing resistance.
Tonsilectomia
In cases of recurrent pharyngitis , the general practitioner may request an opinion from the otorhinolaryngologist for the indication of tonsillectomy , or surgery to remove the tonsils.
The tonsils are responsible for capturing pathogens that enter the mouth.
There are studies that indicate that after removal of the tonsils, the number of severe episodes of pharyngitis drops dramatically, as well as the number of cases of mild pharyngitis.
Some study reviews do not support this type of surgery, but it can provide some comfort to patients with frequent pharyngitis, especially children.
Medicines: what is the best remedy for pharyngitis?
Symptoms of viral inflammation tend to subside without medication since the patient’s own immune system often deals with viruses. But anti-inflammatories and painkillers are usually administered to minimize pain and discomfort.
However, antibiotics are needed to fight the bacteria that cause bacterial pharyngitis.
In addition, the symptoms of the disease will be diminished and will disappear in much less time compared to not taking medication.
Some medications prescribed by doctors for pharyngitis or to combat its symptoms are:
Antibiotics
Antibiotics are indicated when bacterial pharyngitis is found. In this case, they can be used:
- Amoxicillin
- Azithromycin ( Astro );
- Cefadroxila (Cefadroxil);
- Cephalexin ( Keflaxina );
- Clindamicina (Anaerocid)
Anti-inflammatories and painkillers
Anti-inflammatory drugs for pharyngitis help to reduce inflammation and accelerate the recovery process. Analgesics relieve pain and alleviate symptoms. Between them:
- Cetoprofeno (Bi Profenid);
- Ibuprofeno (Advil);
- Paracetamol;
- Acetylsalicylic acid ( Aspirin , recommended for adults only)
Attention!
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Home remedies: natural remedies for pharyngitis
There are some homemade recipes to treat pharyngitis and they can be used in conjunction with medical treatment. But beware! There is no evidence that they work or that they are safe, so be careful when using them.
Gargle with apple cider vinegar
By mixing 1 or 2 tablespoons of apple cider vinegar and a little honey in a glass of warm water, you make a drink that can help with the infection.
Vinegar is known for its antiviral, antifungal and antibacterial properties. You can drink this mixture twice a day until you feel better.
It is also possible to use vinegar for gargling. Mix 1 teaspoon of salt with 1 tablespoon of apple cider vinegar in a glass of warm water and gargle with the liquid 15 minutes before each meal.
Mouthwash with water and salt
The simplest of recipes: just mix 3 tablespoons of salt in 2 cups of warm water and use the mouthwash solution a few times a day. Remember not to swallow . This mixture helps to kill bacteria and viruses, but causes vomiting if swallowed.
Care during treatment
Some care must be taken during treatment to avoid major problems. Are they:
Avoid alcohol consumption
Mixing alcoholic beverages with antibiotics will worsen the inflammatory condition, as well as increasing the risk of having other symptoms.
Take the medicine with some food
It is not necessary to schedule it for mealtime, but have some food in your stomach when taking the antibiotic. This precaution increases the absorption of the medicine by the body.
Get plenty of rest!
Lie as long as possible while dealing with pharyngitis. This is recommended for the body to heal itself, in addition to giving the antibiotic time to fight inflammation.
Cover yourself with clean sheets and avoid the use of ventilators, which can cause respiratory allergies and worsen the disease. Avoid wind currents in the room as well.
If you prefer, you can prepare a solution of salted water and gargle several times a day with this liquid. Just put a teaspoon of salt in a glass of warm water and stir well.
Do not swallow this solution. She will gradually recover her throat, along with the prescribed medication.
Use throat lozenges
Young people and adults can suck lozenges for the throat during the inflammatory pharynx.
Ask your doctor which medicine is best for you. For children, the prescription of sprays is recommended, as they can choke on the tablets.
Obey medication doses and schedules
It is important to strictly follow the doctor’s instructions for medications, especially in the case of antibiotics. Its misuse can create antibiotic-resistant bacteria.
Hydrate
Water is important for everyone, but it is essential for those who are dealing with pharyngitis.
Drink several glasses of this liquid a day, also drinking natural juices, hot tea with honey and lemon and consuming chicken broth.
These suggestions are excellent for restoring the weakened organism and stimulating our defense system to fight the disease. Other suggestions, which are easy to swallow, are: pudding, gelatin, cooked fruits and vegetables.
Cold throat food
Cold drinks, ice cream and popsicles can provide temporary relief from throat discomfort. Let them go if the problem is due to colds or flu.
Speak little
Try to speak as little as possible, to recover your throat by reducing the effort it makes, in addition to avoiding contagion.
Pharyngitis in babies: how to treat?
Babies can get pharyngitis just like anyone. However, it is necessary that there be some care with them, since they cannot do many things alone.
The symptoms present in a baby with pharyngitis are the same as in an adult. Usually the disease is viral, but it can be bacterial, in which case medical treatment is necessary.
If your baby has a fever, is very quiet, has difficulty swallowing or drooling too much, you should take him to the pediatrician.
If the baby has a sore throat, some tips can relieve the condition. Remember that they do not guarantee a cure and only a doctor can tell you what a good treatment is for the child.
Warm bath
A warm bath, with the windows and doors closed, ensures that the water vapor stays in the room, moistening, cleaning and fluidizing the throat.
Wash hands
Washing your hands frequently ensures that fewer microbes are able to come into contact with the child. This goes for both the parents’ and the baby’s hands.
Wrap the child
Remember to protect your child from the cold whenever you take them outside and even indoors.
Keep it at home if you have a fever
If your child has a fever, taking him to daycare or school is not a good idea. It is best that she stay indoors, protected, and go to the pediatrician if the fever persists.
Wash the child’s nose with saline
If the throat shows secretions, the serum can help with cleaning. Remember that if there is pus in the throat, the infection is probably bacterial, and medical care is needed.
Avoid tablets or sprays
Babies should not use throat lozenges or aerosols. The tablets can be swallowed by accident and make them choke and throat sprays have painkillers that can cause cushioning in the mouth, which also facilitates gagging.
Prognosis
In most cases, it is possible to notice improvement in five days, but the treatment does not end there. It is necessary to take the antibiotic every day prescribed by the doctor (often from 7 to 10 days) to ensure that all bacteria that cause pharyngitis are eliminated.
The cure of pharyngitis is usually quick, without major problems or sequelae.
What are the complications of pharyngitis?
There are some possible complications for pharyngitis when it is not treated or when the treatment is not performed correctly. In general, children and people with weakened immune systems are the most likely to suffer from the consequences and damage of pharyngitis. Among the conditions:
Dehydration
If the difficulty in swallowing becomes very serious, it may be possible that the patient is unable to drink fluids, which can lead to dehydration.
Lack of air
If there was an airway obstruction, breathing may be difficult.
Otitis media
Otitis is infection by viruses or bacteria in the ear. Otitis media occurs when the infected region is the middle ear, the air-filled space behind the eardrum. Throat bacteria can move to the ear, causing ear infections, which can cause pain and fever.
Rheumatic fever
Streptococcal infection can trigger this serious disease that may need treatment for life. The rheumatic fever causes inflammation in the heart, blood vessels and joints. It happens especially when pharyngitis is not properly treated.
How to prevent pharyngitis?
Some tips are very effective in reducing the risk of throat discomfort and the need for medication.
Read more: How to prevent typical winter illnesses
Avoid closed places
Especially during the winter, it is important to avoid closed public places. Opening the bus window can prevent the transmission of various diseases, even if it causes a little cold.
Hygiene
Washing your hands frequently, using soap and water, helps to prevent contamination by viruses and bacteria. Using alcohol gel also avoids contamination.
Keep the air moist
You can buy vaporizers or humidifiers for your home to use in the driest times of the year. It is possible to make a homemade humidifier.
Just boil three glasses of water in a pan and then, carefully, take the pan to the room that needs moisture, leaving it there. Evaporating water will moisten the room. However, beware of exaggerations. Excessive moisture can create fungi and bring on other diseases.
Keep warm
Keeping your body warm helps your immunity to stay high. This can prevent several types of diseases, including pharyngitis.
Pharyngitis is an inflammation of the pharynx that causes discomfort in the throat that most of the times is viral and resolves itself, but that can bring serious risks when bacterial.
Remember to avoid crowded places, especially during the winter, when infectious diseases are more common!
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