Sore throat resident survival guide
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Synonyms and keywords:
Overview
Sore throat is one of the most common complaints among patients visiting their primary care physicians. In the United States, approximately 12 million ambulatory care visits are due to sore throat annually. It mostly occurs in children and adolescents. The etiology is mostly acute self- limiting viral infection. Group A streptococcal infection is the most common causative bacteria for acute pharyngitis in adults. As a physician, it is important to identify clinical signs for life-threatening airway obstruction and deep tissue infection and treat them promptly. This section provides a short and straight to the point overview of the sore throat in adults.
Causes
Life Threatening Causes
Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.
- Does not include any known cause.
Common Causes
- Viral upper respiratory tract infection (Adenovirus, rhinovirus, coronavirus, enterovirus, influenza A and B, parainfluenza virus, respiratory syncytial virus, and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). [1][2][3]
- Group A streptococcal (GAS) infection
- Group C and G Streptococcus infection[4]
- Arcanobacterium haemolyticum[4]
- Fusobacterium necrophorum[5]
- Mycoplasma and Chlamydia species[1]
- Corynebacterium diphtheriae
- Acute HIV infection[6]
- Neisseria gonorrhoeae
- Epstein-Barr virus and other herpes viruses cytomegalovirus (CMV) and herpes simplex virus (HSV)[7]
- allergic rhinitis, sinusitis
- gastroesophageal reflux disease
- smoking
- inhalation of dry air (particularly in winters)
- Vocal strain[8]
- Medications: Angiotensin-converting enzyme inhibitors, chemotherapeutic drugs[8]
Diagnosis
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Treatment
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Do's
- The content in this section is in bullet points.
Don'ts
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References
- ↑ 1.0 1.1 Huovinen P, Lahtonen R, Ziegler T, Meurman O, Hakkarainen K, Miettinen A; et al. (1989). "Pharyngitis in adults: the presence and coexistence of viruses and bacterial organisms". Ann Intern Med. 110 (8): 612–6. doi:10.7326/0003-4819-110-8-612. PMID 2494921.
- ↑ Bisno AL (2001). "Acute pharyngitis". N Engl J Med. 344 (3): 205–11. doi:10.1056/NEJM200101183440308. PMID 11172144.
- ↑ Arons MM, Hatfield KM, Reddy SC, Kimball A, James A, Jacobs JR; et al. (2020). "Presymptomatic SARS-CoV-2 Infections and Transmission in a Skilled Nursing Facility". N Engl J Med. 382 (22): 2081–2090. doi:10.1056/NEJMoa2008457. PMC 7200056 Check
|pmc=value (help). PMID 32329971 Check|pmid=value (help). - ↑ 4.0 4.1 Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G; et al. (2012). "Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America". Clin Infect Dis. 55 (10): 1279–82. doi:10.1093/cid/cis847. PMID 23091044.
- ↑ Centor RM, Atkinson TP, Ratliff AE, Xiao L, Crabb DM, Estrada CA; et al. (2015). "The clinical presentation of Fusobacterium-positive and streptococcal-positive pharyngitis in a university health clinic: a cross-sectional study". Ann Intern Med. 162 (4): 241–7. doi:10.7326/M14-1305. PMID 25686164.
- ↑ Tindall B, Barker S, Donovan B, Barnes T, Roberts J, Kronenberg C; et al. (1988). "Characterization of the acute clinical illness associated with human immunodeficiency virus infection". Arch Intern Med. 148 (4): 945–9. PMID 3258508.
- ↑ McMillan JA, Weiner LB, Higgins AM, Lamparella VJ (1993). "Pharyngitis associated with herpes simplex virus in college students". Pediatr Infect Dis J. 12 (4): 280–4. doi:10.1097/00006454-199304000-00004. PMID 8387178.
- ↑ 8.0 8.1 Renner B, Mueller CA, Shephard A (2012). "Environmental and non-infectious factors in the aetiology of pharyngitis (sore throat)". Inflamm Res. 61 (10): 1041–52. doi:10.1007/s00011-012-0540-9. PMC 3439613. PMID 22890476.