Pharyngitis (Sore Throat)

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ICD10 CODE: J02

Inflammation of the throat

Cause

• Most cases are viral
• Bacterial: commonly Group A haemolytic Streptococci, diphtheria in non-immunized children
• Gonorrhoea (usually from oral sex)
• May also follow ingestion of undiluted spirits
• Candida albicans in the immunosuppressed

Clinical features

• Abrupt onset
• Throat pain
• Pain on swallowing
• Mild fever, loss of appetite, general malaise
• In children: nausea, vomiting, and diarrhoea
• The presence of runny nose, hoarseness, cough, conjunctivitis, viral rash, diarrhea suggests viral infection
• The presence of tonsilar exudates, tender neck glands, high fever, and absence of cough suggest a bacterial pharyngotonsillitis (see Pharyngo-tonsillitis)

Differential diagnosis

• Tonsillitis, epiglottitis, laryngitis
• Otitis media if there is referred pain

Investigations

• Throat examination with torch and tongue depressor
• Throat swab for microscopy, C&S
• Blood: Full blood count
• Serological test for haemolytic streptococci (ASOT)

Management

Treatment	LOC
Supportive care Most cases are viral and do not require antibiotics Keep the patient warm Give plenty of (warm) oral fluids e.g., tea Give analgesics, e.g. Paracetamol for 3 days Review the patient for progress For Streptococcal pharyngitis: see Pharyngo-tonsillitis	HC2
Notes:  If not properly treated, streptococcal pharyngitis may lead to acute rheumatic fever and retropharyngeal or peritonsillar abscess Therefore ensure that the full 10-day courses of antibiotics are completed where applicable