Pharyngitis

Pharyngitis

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  Mr. Manikandan.T, RN., RM.,M.Sc(N)., D.C.A .,(Ph.D) Assistant Professor, Dept. of Medical Surgical Nursing, VMCON, Puducherry.
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  DEFINITION • Inflammation ofthe pharynx
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  Acute pharyngitis (SoreThroat): is a sudden painful inflammation of the pharynx, the back portion of the throat that includes the posterior third of the tongue, soft palate, and tonsils.
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  Causes • environmental exposureto viral agents - adenovirus, influenza virus, Epstein-Barr virus, and herpes simplex virus • Bacterial infection - Ten percent of adults with pharyngitis have group A beta-hemolytic streptococcus (GABHS), which is commonly referred to as group A streptococcus (GAS) or streptococcal pharyngitis. • When GAS causes acute pharyngitis, the condition is known as strep throat • Other bacterias - Mycoplasma pneumoniae, Neisseria gonorrhoeae, H. influenzae type B • Poorly ventilated rooms, • viral pharyngitis peaks during winter and early spring • Viral pharyngitis spreads easily in the droplets of coughs and sneezes • unclean hands that have been exposed to the contaminated fluids.
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  CLINICAL FEATURES • Pain– Body, swallowing • Dry cough • Fever • Vasodilation • Edema • Redness and swelling in the tonsillar pillars, uvula, and soft palate. • A creamy exudate may be present in the tonsillar pillars • Lymph node enlargement
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  DIAGNOSIS • H.C • P/E •Culture • Blood investigation • Rapid streptococcal antigen test [RSAT]
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  Treatment • Antibiotics –Doxycycline 100 mg twice daily – 5-7 days • Once-daily azithromycin may be given for only 3 days due to its long half-life. • A 5- or 10-day course of cephalosporin may be prescribed. Five-day administration of cefpodoxime and cefuroxime has also been successful in producing bacteriologic cures. • Anti inflammatory -ibuprofen • Pottasium permonganate gargles • Soft, bland and warm diet
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  Nutritional Therapy • Aliquid or soft diet. • Cool beverages, warm liquids, and flavored frozen desserts such as Popsicles are often soothing. Occasionally, the throat is so sore that liquids cannot be taken in adequate amounts by mouth. • In severe situations, intravenous (IV) fluids may be needed. • Otherwise, the patient is encouraged to drink as much fluid as possible (at least 2 to 3 L per day).
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  CHRONIC PHARYNGITIS • Chronicpharyngitis is a persistent inflammation of the pharynx. Charecterised by multiple, white elongated keratinized epithelial outgrowths project from the surface of tonsil, base of tongue or posterior pharyngeal wall.
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  • It iscommon in adults who work in dusty surroundings, use their voice to excess, suffer from chronic cough • Habitually use alcohol and tobacco.
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  TYPES OF CHRONICPHARYNGITIS: • Hypertrophic: characterized by general thickening and congestion of the pharyngeal mucous membrane • Atrophic: probably a late stage of the first type (the membrane is thin, whitish, glistening, and at times wrinkled) • Chronic granular (“clergyman’s sore throat”), characterized by numerous swollen lymph follicles on the pharyngeal wall
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  Clinical Manifestations • Foreignbody sensation • Constant sense of irritation or fullness in the throat, mucus that collects in the throat and can be expelled by coughing, and difficulty swallowing. • A sore throat that is worse with swallowing in the absence of pharyngitis suggests the possibility of thyroiditis.
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  Medical Management • Relievingsymptoms- avoiding exposure to irritants, and correcting any upper Respiratory infection • Nasal congestion may be relieved by short-term use of nasal sprays or medications containing ephedrine sulfate(Kondon’s Nasal) or phenylephrine hydrochloride (Neo-Synephrine). • For allergy, one of the antihistamine decongestant medications, such as Pseudoephedrine(Sudafed) or brompheniramine/pseudoephedrine, is prescribed orally every 4 to 6 hours. • Aspirin or acetaminophen is recommended for its anti- inflammatory and analgesic properties. • For adults with chronic pharyngitis, tonsillectomy is an effective option