Pharyngitis pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]
Overview
The pathogenesis of the sore throat due to pharyngitis is poorly understood.[1] The pharynx is often the first site of infection for many contagious diseases such as pharyngitis because pathogens such as viruses and bacteria often settle in the nasopharynx though inhalation or through droplets. Viral pharyngitis usually transmit from person to person through direct touch or through droplets transmission.[2] The foreign invader reproduces rapidly after settling on the nasopharynx. Generally pharyngitis is a primary disease, but may be associated with systemic disorders such as the acute retroviral syndrome, or part of a more generalized upper respiratory tract infection.[3]
Pathophysiology
- Viruses, such as adenovirus, cause inflammation of the pharyngeal mucosa by direct invasion of the mucosa or secondary to suprapharyngeal secretions.[4] Other viruses, such as rhinoviral infections produce bradykinin and lysyl bradykinin, which are known inflammatory mediators that can excite nerve endings in the pharynx to cause pain.[5]
- The Group A streptococcus releases exotoxins and proteases. Erythrogenic exotoxins are responsible for the development of the scarlatiniform exanthem. Secondary antibody formation because of cross-reactivity may result in rheumatic fever and valvular heart disease. Antigen-antibody complexes may lead to acute poststreptococcal glomerulonephritis.[6]
- Untreated GAS pharyngitis can result in suppurative complications including bacteremia, otitis media, meningitis, mastoiditis, cervical lymphadenitis, endocarditis, pneumonia, or peritonsillar abscess formation. Nonsuppurative complications include rheumatic fever and poststreptococcal glomerulonephritis.[7]
References
- ↑ Ferri, Fred (2005). Md consult/first consult 14-month subscription : combo retail pack. Place of publication not identified: Elsevier Saunders. ISBN 9781416026075.
- ↑ Kline JA, Runge JW (1994) Streptococcal pharyngitis: a review of pathophysiology, diagnosis, and management. J Emerg Med 12 (5):665-80. PMID: 7989695
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.
- ↑ Usatine, Richard (2013). The color atlas of family medicine. New York: McGraw-Hill. ISBN 978-0071769648.
- ↑ Proud D, Naclerio RM, Gwaltney JM, Hendley JO (1990) Kinins are generated in nasal secretions during natural rhinovirus colds. J Infect Dis 161 (1):120-3. PMID: 2295843
- ↑ Usatine, Richard (2013). The color atlas of family medicine. New York: McGraw-Hill. ISBN 978-0071769648.
- ↑ Usatine, Richard (2013). The color atlas of family medicine. New York: McGraw-Hill. ISBN 978-0071769648.