Pharyngotonsillitis: what it is, causes and treatment

What is pharyngotonsillitis?

Pharyngotonsillitisis inflammation ofthe pharynx and palatine tonsils. The pharynx is part of the upper respiratory tract. On the other hand, the palatine tonsils play a role as part of the systemic immune system.

They are responsible forprocessing certain antigens (foreign proteins that enter our body), since the tissue that makes it up is capable of producing immune cells, such as T and B lymphocytes.

Important: Pharyngotonsillitisrepresents one of the most common causes for which a person goes to a doctor. In the U.S. alone, 2% of adults who go to the doctor are for symptoms of pharyngitis. (1) In children, that percentage reaches up to 6%. (2)

Causes of pharyngotonsillitis

Inflammation of the pharynxandpalatine tonsils (also known as tonsils), can occur for a variety of reasons, although some predominate more than others, as will be seen below.

Virus

They are the most frequent cause of Pharyngotonsillitis . They represent 30 to 60%of the causes in adults. The incidence of infectious causes of pharyngotonsillitis in children is even higher, especially between 4 and 7 years of age.

Note: The viral agents that most frequently inflame these parts of our body are respiratory virusestag. For example, the causes of the common cold (adenovirus, rhinovirus, influenza, coronavirus and respiratory syncytial virus).

There are classes of viruses, whose main objective is not the respiratory tract, but which can also cause inflammation. These are theEpstein-Barr virus, herpes simplex virus, cytomegalovirus, and HIV .

bacterium

In adults, this proportion is lower (5-15%). (4) Of the GABHS group, the main bacterial agent is Streptococcus pyogenestag. Other bacteria, which are not part of that group, can also cause this infection.

An example of them are Mycoplasma pneumoniae, Chlamydia pneumoniae , and Arcanobacterium haemolyticustag. But for these bacteria to be responsible are relatively rare events.

Note: Unlike Viral pharyngitis , bacterial infections run the risk of producing suppuration (production of pus), which can affect other adjacent structures.

Air

Important: Minimizing contact, especially children, with people who currently have or have had an infection is helpful in preventing the spread of infection.

Direct contact

As we explained earlier, not all infectious causes of tonsillopharyngitisderive from agents that are spread in tiny airborne droplets of saliva. Someare transmitted in another way .

For example, cytomegalovirus can be transmitted through Direct contact with an infected person’s bodily fluids (saliva, urine, blood, semen, or vaginal fluids). (5)

Upon contact with the person, the virus can cause Infectious mononucleosis , also responsible for inflammation of the tonsils.

Symptoms of tonsillopharyngitis

In the Clinical context, pharyngotonsillitis is easily recognizable by the set of signs and symptoms that characterize it. However, distinguishing aViral pharyngitis from a bacterial one, without laboratory tests, is difficult.

However, doctors have created a scale based on thepatient’s symptoms. Depending on the score, there is a certain range of probability that the pharyngitis is bacterial or not.

If the score is equal to or greater than 4, the chances of bacterial pharyngitisare more than 50%. Conversely, if the percentage is equal to 1 or less, the odds are reduced to less than 10%.

Next, we will explain some of the most common symptoms.

Fever

Fever is a common bodily response that our system uses to deal with some danger. High temperatures make our body an inhospitable environment for some infectious agents , managing to neutralize them.

Note: Fever may be accompanied by chills, muscle aches, andexcessive sweating. If the cause of pharyngitis is bacterial, the fever can even reach temperatures higher than 38.5 °C.

Inflamed tonsils

Regardless of the cause, a virus or bacteria can Inflame the tonsilstag. This inflammation makes the person uncomfortable when swallowing, which hinders their daily routine.

In Infectious mononucleosis , the tonsils are so enlarged and inflamed that they can come in contact with the Uvula (also known as the ‘bell’ or ‘mouth bell’).

Swollen neck glands

The neck lymph nodesare affected, in this case. These are divided into anterior (those that are in front) and posterior (those that are in the back of the neck).

Important: When a Lymph Nodeswells, it becomes a painful, hard, palpable mass in the neck (usually not palpable). An infection involving only the front lymph nodes suggests that a bacterium may be responsible.

Throat pain

This is the common cause that people refer to when they go to the doctor. It is characterized bypain and discomfort , especially when Swallowing food or saliva .

Many viruses and bacteria have a certain affinity for the cells of the pharyngeal mucosa,which makes them the seat of many infections. Once there, they begin to replicate and release all kinds of antigens and even toxins.

Headache

Headaches tend to have an abrupt onset, but subside once the infection begins to be treated, usually with no sequelae.

Cough

 

In our airways, there are small villithat drag upwards, in a movement similar to a sweep, any substance that adheres to the surface. Once they’re out enough,coughing or sneezing seeks to expel them completely.

Runny nose

Also known as Runny Nosetag. Certain viruses, which cause theCommon Cold , cause this phenomenon, because the cells in our nose are stimulated and produce a greater amount of mucus (greater than there normally is).

This produces those uncomfortable, and even embarrassing, Profuse Nasal Secretionsall the time. As the thickness of the mucus layer grows disproportionately, it is more difficult forodoriferous substances to establish contact with the neurons responsible for smell.

Note:ToRunny Nose is the reason why your sense of smell (and taste, too) is dulled during a cold or flu.)

Halitosis

The accumulation of bacteria in the throat, sinuses and/or nose can cause this bad breathtag. Relieving inflammation with the right treatment will reduce bad breath.

dysphonia

The Contraction of the muscles of the larynxand the vocal cords allows us to correctly articulate and pronounce the words we wish to express. When the throat is inflamed, this becomes difficult.

Generally, it is what is known as the Hoarse Voice that people suffer from when their throat is inflamed.

loss of appetite

If the throat is inflamed , the person’s desire to eat will decrease significantly, due to the irritation and pain it produces every time they swallow.

Tip: Non-solid foods, such as soups and broths, are recommended to maintain the level of nutrients and electrolytes in the body.

Treatment for tonsillopharyngitis

Tonsillopharyngitis is rarely fataltag. But, its long-term complications are significant. Rheumaticfever and rheumatic heart disease (a direct consequence of the former) is an important cause of cardiac death in developing countries.

Therefore, it must be treated appropriatelytag. The main therapeutic objective includes reducing symptoms, preventing contagion and transmission of the disease, and avoiding its complications.

Next, we will mention some of its most frequent treatments.

antibiotics

If the result suggests that it is due to a bacterium, an empirical treatment should be applied and tests such as a pharyngeal smear , whose material is used in rapid antigen tests or pharyngeal culture, should be carried out to determine the presence, or not, of bacteria.

Note: The antibiotic par excellence to treat pharyngitis caused by GABHS is Penicillin, both for adults and children. Those allergic to penicillin are givenCephalosporins or erythromycin.

constant hydration

Maintaining electrolytelevels at adequate levels is essential. Fever and sweating cause the sick person to lose excessive body fluids.

Tip: Not very solid foods, soft drinks and even frozen desserts are some of the foods that a person with a sore throat can consume.

rest and rest

Note: The person should Avoid Doing Physical Exercises or any strenuous activity, since they risk losing much more body fluids than necessary.

Tonsillectomy

Also known as to tonsillectomytag. It is the surgical removal of thePalatine Tonsilstag. Very few patients need to go to these extremes.

Generally, candidates for a tonsillectomy are those patients who frequently suffer from strep throat , demonstrate allergic reactions to multiple antibiotics, or have a history of peritonsillar abscesses.

Important:Currently, the effectiveness of this procedure is questioned. As in all surgery, there is arisk of complications, such as bleeding or infections. Up to 3.9% of patients who underwent tonsillectomies were admitted to the emergency department due to complications.(6)

How to avoid pharyngotonsillitis?

Fortunately, pharyngoatonsillitis can be avoided with a series of measures that reduce the risk of contagion. Next, we will mention some of these.

Keep distance from sick people

If you know that an acquaintance, family member or friend has suffered from a persistent sore throat, abundant runny nose and even a fever, it is best to stay away from said person for now.

The same goes for children. Although it is not at all uncommon for a child to suffer from strep throat,if we know that there is a risk in letting them come into contact with a person who has recently been sick, it is best to keep them away.

Avoid sharing personal belongings with infected people

An object that is capable of carrying an infection is called a Phomitestag. These can beobjects of daily use : clothing, utensils, furniture, car handles, doors of a public building, stair railing, etc.

Tip: If we are in a public place , where hundreds of people spend daily, they should Minimize Contactwith these surfaces. If this is not possible (such as a door handle),avoid bringing your hand to your face immediately after touching it.

Cover your mouth when sneezing or coughing

It is a Basicand important hygiene rule. Coughingor sneezingsuddenly expels millions of particles into the ambient air. Other people inadvertently inhale these particles.

The optimal isto cover our mouth or nose with our elbowwhen coughing or sneezing, directing our face in the opposite direction to where other people are.

Wash your hands constantly

Another unlikely rule. Effectiveand complete hand washing substantially reduces the chances of a virus or bacteria, capable of evading our defenses, entering our body.

After touching fomites or shaking hands with people in public, avoid bringing that part of your body to your mouth, nose, or eyestag. Then, when the opportunity arises, wash your hand. That way, you avoid contagion.

Key Findings

• Symptoms are Sore Throats , fever, swollen lymph nodes, swollen tonsils, and General Malaise .
• For most cases, hydration and rest are the best weapons to combat virus infections.
• Using Basic Hygiene Rules (washing your hands, covering your mouth when coughing or sneezing) reduces the risk of contagion, protecting yourself and others.