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Acute Pharyngotonsilitis

Acute pharyngitis is characterized by inflammation of the pharynx, with symptoms including erythema, edema, and exudates. It can be caused by environmental factors, infectious agents, and inflammatory conditions, with specific presentations such as strawberry tongue and scarlet fever rash. Diagnosis is aided by the McIsaac scoring system and throat cultures, while treatment focuses on symptomatic relief and antibiotics to prevent complications like acute rheumatic fever.

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17 views18 pages

Acute Pharyngotonsilitis

Acute pharyngitis is characterized by inflammation of the pharynx, with symptoms including erythema, edema, and exudates. It can be caused by environmental factors, infectious agents, and inflammatory conditions, with specific presentations such as strawberry tongue and scarlet fever rash. Diagnosis is aided by the McIsaac scoring system and throat cultures, while treatment focuses on symptomatic relief and antibiotics to prevent complications like acute rheumatic fever.

Uploaded by

thamizh1035
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

Acute Pharyngitis

• Pharyngitis refers to inflammation -pharynx,


• erythema,
• edema,
• exudates,
• enanthem (ulcers, vesicles)
Causes
• Environmental exposures-Tobacco,smoke, air pollutants,
and allergens.
• Caustic substances,hot food, and liquids;
• Infectious agents.
• Inflammatory conditions.
• The surface of the tongue can resemble a strawberry
when the papillae are inflamed and prominent
(strawberry tongue).

• Initially, the tongue is often coated white, and with the


swollen papillae, it is called a white strawberry tongue.

• When the white coating is gone after a few days, the


tongue is often quite red and is called a red strawberry
tongue.
• Patients infected with GAS that produce streptococcal
pyrogenic exotoxin A, B, or C may demonstrate the fine, red,
papular (sandpaper) rash of scarlet fever.
• It begins on the face and then becomes generalized.
• The cheeks are red, and the area around the mouth is less
intensely
• red (more pale), giving the appearance of circumoral pallor.
• The rash blanches with pressure, and it may be more intense
in skin creases,especially in the antecubital fossae, axillae,
and inguinal creases (Pastia lines or sign). Pastia lines are
sometimes petechial or slightly hemorrhagic.
• Capillary fragility can cause petechiae distal to a
tourniquet or constriction from clothing, a positive
tourniquet test or Rumpel-Leeds phenomenon.
• Erythema fades in a few days, and when the rash
resolves, it typically peels like a mild sunburn.
• Sometimes there is sheetlike desquamation around the
free margins of the fingernails.
McIsaac Scoring
• Criteria developed for adults by Centor and modified for
children by McIsaac give one point for each of the
following criteria:
• History of temperature >38°C (100.4°F),
• Absence of cough,
• Tender anterior cervical adenopathy,
• Tonsillar swelling or exudates, and
• Age 3-14 years.
• It subtracts a point for age ≥45 years
Other investigations
• Throat culture,
• Rapid antigen-detection tests (RADTs), or
• PCR tests
• are the diagnostic tests for GAS most available in
routine clinical care.
• Throat culture plated on blood agar remains the gold
standard for
diagnosing streptococcal pharyngitis.
TREATMENT
• Specific therapy is unavailable for most viral
pharyngitis.
• An oral antipyretic/analgesic agent.
• Anesthetic sprays and lozenges (often containing
benzocaine, phenol, or menthol) can provide local relief.
• Systemic corticosteroids are sometimes used in children
who have evidence of upper airway compromise caused
by mononucleosis.
• Most untreated episodes of GAS pharyngitis resolve
uneventfully within a few days, but early antibiotic therapy
hastens clinical recovery by 12-24 hours and also reduces
suppurative complications of GAS pharyngitis such as
peritonsillar abscess and cervical adenitis.
• The primary benefit and intent of antibiotic treatment is the
prevention of acute rheumatic fever (ARF); it is highly
effective when started within10 days of onset of illness.
• Antibiotic therapy does not prevent acute poststreptococcal
glomerulonephritis (APSGN).

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