Pharyngitis - how to recognise it

Most patients suffer from viral pharyngitis, but we can also struggle with bacterial pharyngitis. This disease involves the mucous membranes of the throat, sometimes also the tonsils. In the case of bacterial pharyngitis, we are not bothered by a runny nose or cough. These are typical symptoms of pharyngitis with a viral origin. Untreated sore throat inflammation can lead to acute complications.

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What is pharyngitis?

Pharyngitis is an inflammation involving mostly only the mucous membranes of the throat. In some cases it can also attack the tonsils. The most common symptom is severe redness of the throat and severe pain that causes difficulty swallowing. Most patients dealing with this disease are children aged 4-7 years. The reason for this is the immature immune system of the youngest and the differences in the anatomy of the airways of different individuals.

The sore throat itself can be treated as a cold, but pharyngitis is a disease whose course can be quite severe depending on what it is caused by and the body condition of the individual patient. Compared with other diseases, pharyngitis is distinguished by problems with swallowing, increased throat discomfort such as burning, dryness or hoarseness. During the illness, a fever, runny nose or cough may occur. However, the symptoms depend on what is causing the illness.

What are the causes of pharyngitis?

The most common causes of pharyngitis are atmospheric factors such as wind, especially when combined with rain and cold weather. All it takes is a failure to adjust clothing to the conditions outside and illness is guaranteed. In addition, catching pharyngitis is also facilitated by a lowered immunity. If our diet is poor in nutritional values such as vitamins, micro- and macro-elements or protein, the body does not have the strength to fight the disease, making it much easier for us to fall ill. The weaker the immunity, the more severe the course of the disease itself may be. 

To protect yourself from illness, it is worth taking care of your immunity. How can you do this? You should:

• sleep at least 8 hours a day
• eat a healthy and varied diet (remember plenty of fruit and vegetables),
• dress appropriately for the weather (don't overheat),
• lead an active lifestyle.

During the autumn and winter season, it is particularly difficult to protect oneself from infection. At that time, it is advisable not to visit sick people, to isolate oneself from relatives who have symptoms of a cold or a specific illness, and to avoid large concentrations of people. When returning home, wash your hands thoroughly, and when at work or school, do so as often as possible. When visiting a clinic or hospital, e.g. with a sick child, remember to wear a protective mask and not to touch handles or buttons in the lift.

What are the types of pharyngitis and what are their characteristics?

There are two main types of pharyngitis: viral and bacterial. Fungal pharyngitis also occurs, but it is a fairly rare ailment. The two most common types differ not only in the cause of the disease, but also in the symptoms and treatment.

Viral inflammation is caused by a variety of viruses, e.g. influenza virus, paragrpa virus, coronavirus, enterovirus, adenovirus or rhinovirus. It can also be caused by the herpes virus, thus accompanying herpes pharyngitis. Researchers estimate that pharyngitis can be caused by up to 200 types of viruses. As many as 70% of cases of pharyngitis in children and up to 90% in adults are viral in origin. Viral infections develop relatively quickly, usually 1 to 6 days after infection. 

One form of viral pharyngitis is infectious mononucleosis. Characterised by an acute course of the disease. It is caused by the Epstein-Barr virus, which is transmitted by the droplet route, usually through saliva. Although one of the symptoms is pharyngitis, the patient also suffers from enlargement of the lymph nodes, spleen and liver.

Bacterial pharyngitis is mostly caused by beta-haemolytic streptococcus A (or Streptococcus pyogenes).This type of illness is called streptococcal pharyngitis. Bacteria spread to the tonsils, resulting in pharyngitis (also known as purulent pharyngitis). The symptoms of bacterial pharyngitis are very intense and localised (only the throat is affected). 

Viral pharyngitis is usually milder than bacterial pharyngitis. How else can you recognise the type of pharyngitis? In the case of viral inflammation, we can observe redness of the throat and swelling and redness of the tonsils. Vesicles with fluid (serous exudate) are also a characteristic symptom for this type of infection. Bacterial inflammation manifests as a dark red colouring of the pharyngeal mucosa and reddening of the tonsils. This is accompanied by a white coating, and the uvula (this is the soft tissue hanging at the end of the palate) is swollen. We may also see a grey coating on the tongue. In addition, the symptoms are accompanied by a fever above 38°C. If we are not sure, we can also check sample photos of the throat in a search engine by typing in, for example, "posterior pharyngeal wall inflammation - photos" and compare with the state of our own mucous membranes.

Accurate identification of the type of disease is very important, because on this basis the treatment is selected. In the case of a viral infection, symptomatic treatment is used. For bacterial inflammation, the doctor may prescribe an antibiotic.

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What are the symptoms of pharyngitis?

The symptoms of pharyngitis vary depending on the cause of the illness. 

Viral pharyngitis - symptoms:

• sore throat of varying intensity,
• burning and/or scratching of the throat,
• rhinitis of varying intensity,
• dry cough,
• raised body temperature (usually no higher than 37.5°C).

If you suffer from acute pharyngitis, you may develop a high fever, up to 39°C. There may also be an earache or headache.

Viral pharyngitis - how long does it last?

The symptoms of viral inflammation are persistent. Therefore, although they usually subside on their own after about a week, it is worth taking measures to alleviate them. We can resort to medical preparations for sore throats (e.g. sprays, tablets, rinses) and rhinitis. If a fever occurs, we can reduce it with, for example, paracetamol or ibuprofen. In addition to medication, it is worth remembering to drink warm, but not hot, beverages and to humidify the air to relieve the cough. 

And what are the symptoms of bacterial pharyngitis?

• persistent sore throat
• problems swallowing,
• fever over 38°C,
• chills,
• severe reddening of the throat,
• purulent infiltration of the tonsils,
• enlarged lymph nodes,
• nausea and/or vomiting,
• abdominal pain.

The symptoms of a bacterial infection usually last up to 10 days, but in this case, appropriate treatment is necessary. When the doctor prescribes an antibiotic, we should take it as prescribed. Just because we feel better does not mean that we can stop the treatment. In addition to taking the medication and bringing down the temperature, it is a good idea to get plenty of rest so that the body can recover.

Pharyngitis - treatment in children and adults

The form of treatment for pharyngitis differs between children and adults. If you suspect illness in a child, see your doctor first. This is particularly important if one of the symptoms is fever. The doctor will determine what type of pharyngitis the child is dealing with and match it with the appropriate treatment. In the case of viral pharyngitis, these will include medication to relieve complaints such as sore throat, runny nose or cough and fever. The child will also be advised to drink plenty of water and to rest. In the case of a bacterial infection, it will be necessary to take an antibiotic. It is important that this is given to the child according to the doctor's instructions, as only the correct use of the antibiotic will cure the bacterial infection. Failure to treat bacterial pharyngitis can result in various complications, such as sinusitis, middle ear infection or even rheumatic fever. 

Recommendations used for children are also given to adults. It's important to get plenty of rest during illness, lie in bed, air your home and drink plenty of fluids (preferably water). In fact, the main differences in treatment relate to the form of the drugs. For the youngest children, inhalations, throat sprays and cough and fever syrups are most commonly used. Older children who can already suck without swallowing and adults can be given lozenges. The throat can also be gargled, which is recommended more for teenagers and adults. Of course, inhalations or cough syrups can also be prescribed for adults. In the case of an antibiotic, younger children will be given a suspension and adults will be given tablets to swallow.

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How to deal with the symptoms of pharyngitis?

A sore throat can bother us for a variety of reasons. It is not always inflammation. The pain itself can also be caused by dry air, shouting for a long time (e.g. during a concert) or allergies. So how do we recognise that we are dealing with pharyngitis? If you have worrying symptoms, it is a good idea to see your doctor. When to do this? When you observe, for example:

• reddening of the throat (sometimes also of the tonsils),
• increased temperature
• chills,
• problems swallowing,
• enlarged lymph nodes,
• cough,
• rhinitis. 

The sooner we go to the doctor, the easier it will be to cure pharyngitis. We must not underestimate it, because an untreated disease can cause dangerous complications. 

When recovering from a sore throat, it is useful to use different ways to relieve a sore throat:

• medication prescribed by a specialist,
• drinking plenty of fluids
• rinsing the throat with camomile or sage infusion,
• humidifying the air at home,
• airing the home,
• adjusting your diet to your swallowing capacity (e.g. eating cream type soups),
• avoiding alcohol
• avoiding smoking
• avoiding hot spices.

Is an antibiotic always necessary for pharyngitis?

Whether the treatment of pharyngitis will be based on an antibiotic depends on the type of pharyngitis and the individual patient's case. If there is viral inflammation, an antibiotic will not be effective. An antibiotic for pharyngitis is only used for bacterial infections to shorten the duration of the illness and relieve symptoms. The use of an antibiotic also prevents dangerous complications such as rheumatic fever. 

The type of antibiotic to be prescribed depends on the patient. If he or she is not allergic to penicillin, this will usually be the doctor's first choice. He or she may also prescribe an antibiotic from the cephalosporin group or a macrolide antibiotic. During treatment, the patient must strictly follow the doctor's instructions. Neither lower nor higher doses of antibiotics can be used. Intervals between doses should be as recommended. Stopping treatment will result in a relapse. If left untreated, the disease can also cause chronic pharyngitis.

If we are in doubt as to whether we should take an antibiotic, we can consult a doctor quickly online. The patient can take a picture of their throat with their phone and send it to the doctor, who will be able to look at the infection during the visit. In addition, he will take a history and make a diagnosis. He or she can also give us a prescription. If we have difficult access to the clinic and there are no quick appointments, it is worth using online advice. 

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Summary

Pharyngitis gives persistent symptoms, so it is worth taking treatment as soon as possible. To do this, we must first determine what type of illness we are dealing with. The main determinant is the symptoms. In the case of a viral infection, a sore throat is accompanied by a runny nose and dry cough. When we are dealing with a bacterial pharyngitis, the symptoms will focus exclusively on the throat. A high fever may also occur. Which treatment is used depends on both the type of inflammation and the individual patient's case. An antibiotic is not always necessary, but when one is prescribed, it should be taken exactly as the doctor has advised. If untreated or not treated at all, pharyngitis can cause severe complications.