Pharyngitis

Pharyngitis is inflammation of the pharynx, typically presenting with sore throat, pain on swallowing, and sometimes fever or swollen lymph nodes. It is a common condition that affects people of all ages and is usually self-limited.

Most cases are viral, transmitted by respiratory droplets. Bacterial pharyngitis is less common but important, with group A beta-hemolytic Streptococcus (GAS) being the classic cause of streptococcal pharyngitis. Other bacteria and fungi are rarer, and noninfectious causes such as allergies, irritants, and reflux can mimic pharyngitis.

Symptoms vary by cause. Viral pharyngitis often includes cough, nasal symptoms, hoarseness, and fatigue; GAS pharyngitis more commonly presents with fever, tonsillar exudates, tender anterior cervical nodes, and absence of cough.

Diagnosis relies on clinical assessment and laboratory testing when appropriate. The Centor criteria estimate the likelihood of GAS infection. Rapid antigen detection testing (RADT) and throat culture confirm GAS when indicated.

Treatment depends on the cause. Viral pharyngitis is managed with supportive care: fluids, analgesics, throat soothing measures, and rest. GAS pharyngitis requires antibiotics, typically penicillin V or amoxicillin for about 10 days; alternatives exist for penicillin allergy. Antibiotics may shorten symptoms and prevent transmission, but should be used only when GAS is confirmed or strongly suspected.

Complications of untreated GAS pharyngitis can include acute rheumatic fever and, less commonly, acute glomerulonephritis or peritonsillar abscess. Most patients recover within a week with appropriate care.

Prevention focuses on good hand hygiene, avoiding sharing utensils or saliva, and staying away from others when contagious. Vaccines are not available for pharyngitis in general.