Overview of Human Upper and Lower Respiratory Tract Viral Infections
Sunit K. Singh in Human Respiratory Viral Infections, 2014
Patients with pharyngitis present with the following complaints: sore throat, difficulty in swallowing, mild fever, and sometimes, enlarged lymph nodes in the neck (lymphadenopathy). Headache and malaise may accompany these complaints.35,42,43 In most cases, pharyngitis is associated with other URTI complaints.42 Parainfluenza viruses, influenza viruses, AdV, enteroviruses, and rhinoviruses are the common causes of the disease.35,38,44,45 When a viral pathogen is involved, the disease is usually self-limiting. Additional testing is suggested in patients with an atypical presentation or suspected bacterial coinfection.35,42
Respiratory Infections
Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar in Handbook of Refugee Health, 2021
Pharyngitis is mostly caused by viruses (adenovirus and rhinovirus) but also by bacteria (Group A streptococcus). Differential diagnosis includes epiglottitis and retropharyngeal abscess (fever, chills, voice change, dysphagia, neck stiffness and feeling of lump in throat). Untreated Group A streptococcus can cause rheumatic fever, post-streptococcal glomerulonephritis, toxic shock and abscess. Consider gonococcal infection if risk factors are present. Symptoms include fever, malaise, hoarse voice, sore throat and myalgia. Treatment is supportive for viral infections, which should resolve in up to 10 days; if a bacterial infection is suspected, for example, streptococcal, give 250–500 mg penicillin V four times a day orally for 10 days in those without penicillin allergy. Avoid amoxicillin in suspected EBV, as it leads to rash.
Head and neck infections
S. Musheer Hussain, Paul White, Kim W Ah-See, Patrick Spielmann, Mary-Louise Montague in ENT Head & Neck Emergencies, 2018
Acute pharyngitis refers to irritation/inflammation or infection of the pharynx and is commonly known as sore throat. Usually it is caused by viral infection but can also be a reflection of bacterial infection, most commonly by group A Streptococci. Other causes include allergy, trauma and toxins. Acute pharyngitis can occur as a part of a generalised upper respiratory tract infection or localised throat problem. On examination the posterior pharyngeal wall shows prominent lymphoid tissue along with generalised inflammation of the palate and tonsils with or without exudates (Figure 8.1). However, in the majority of the cases, the oropharynx has a normal appearance. Based on history and examination, it is difficult to distinguish between viral and bacterial causes of acute pharyngitis. However, few of these patients are referred for ENT assessment, as the condition is generally self-limiting with conservative management, including analgesia, fluids and rest. Oral antibiotic therapy may also be prescribed, though a recent Cochrane review shows that this shortens the duration of symptoms by only 16 hours compared to placebo, although the relatively small risk of associated complications is reduced.1 Therefore, oral antibiotic therapy is not recommended for routine use in uncomplicated cases of acute pharyngitis.
MEFV gene variants in children with Henoch-Schönlein purpura and association with clinical manifestations: a single-center Mediterranean experience
Published in Postgraduate Medicine, 2019
Rabia Miray Kisla Ekinci, Sibel Balci, Atil Bisgin, Bahriye Atmis, Dilek Dogruel, Derya Ufuk Altintas, Mustafa Yilmaz
A total 144 patients were enrolled the study, 59 (41%) females and 85 (59%) males. Mean diagnosis at age was 7.8 ± 3 (minimum 2.7, maximum 15.6) years, follow-up duration was 26.1 ± 2.6 (minimum 6, maximum 155) months. All patients had purpura at the time of diagnosis. Detailed history revealed a presence of preceding infection in 91 (63.2%) of the patients, most commonly pharyngitis. The symptoms of the patients at diagnosis and recurrence, and laboratory parameters are shown in Table 1. Twenty-three patients (16%) had recurrence with a median time of 41 days (minimum 30 days, maximum 5.7 years) after disease onset. While urinary findings were present in 36 (25%) patients, only 11 of them underwent renal biopsy for persistent or increasing proteinuria/hematuria without deterioration in renal functions. Only one of these patients had normal findings in renal biopsy. Renal biopsy results of the remaining 10 patients with biopsy-proven HSP nephritis are shown in Table 1.
Unilateral Acute Idiopathic Maculopathy Associated with Streptococcal Pharyngitis, A Case Report
Published in Ocular Immunology and Inflammation, 2022
Clare L. Shute, Usha Chakravarthy, Clara E. McAvoy
Given the temporal relationship between developing a sore throat and experiencing unilateral visual loss, biochemical, hematological, and serological investigations were carried out 2 weeks following initial presentation with acute pharyngitis. Biochemistry showed a CRP of 19.2 (normal range <5 mg/L) and a mild uremia of 9.9 mmol/L (normal range 2.4–7.8 mmol/L). Hematological investigations showed an ESR of 20 mm/hr (normal range 1–12 mm/hr) and a WCC of 4.7 x109/L (normal range 4–10 x109/L). Serological investigations revealed a raised anti-streptolysin titer (ASOT) at 800 IU/ml and Streptococcus Anti-DNAse-B (ADB) antibody at 400 U/ml (ASOT > 200 IU/ml and ADB > 200 U/ml are suggestive of current/recent infection according to local laboratory protocol). The anti-streptolysin titer remained raised at 800 IU/ml 2 months later.
Lemierre’s syndrome treated operatively
Published in Baylor University Medical Center Proceedings, 2020
Allison T. Lanfear, Mohanad Hamandi, Joy Fan, Madison L. Bolin, Michael Williams, J. Michael DiMaio, John Waters
Lemierre’s syndrome (LS) is a severe sequela of an acute oropharyngeal infection, characterized by septic thrombophlebitis of the internal jugular vein (IJV) frequently complicated by metastatic infections.1–3 LS is most commonly caused by Fusobacterium necrophorum. The incidence of LS appears to be decreasing due to antimicrobial therapy; however, it affects 1 per 1 million and confers a mortality rate of up to 12%.4 Common presenting symptoms include prolonged pharyngitis, lateral neck pain, fever, shortness of breath, tachycardia, and hypotension.5,6 When promptly administered, antibiotics can be effective. However, complications may arise that require additional intervention. We report a case of LS in a young man, complicated by severe right-sided pleural effusion that resisted intrathoracic lytic treatment and required surgery.
Related Knowledge Centers
- Cough
- Fever
- Inflammation
- Lymph Node
- Pharynx
- Rhinorrhea
- Sore Throat
- Headache
- Throat
- Hoarse Voice