Acute pharyngitis

Acute pharyngitis is characterized by acute onset of sore throat; the absence of cough, nasal congestion and discharge suggests a bacterial etiology.

Rapid antigen detection tests allow immediate point-of-care assessment of group A Streptococcus (GAS) pharyngitis. However, nucleic acid amplification (via polymerase chain reaction) testing for GAS is becoming more common and is comparable to throat culture in sensitivity and specificity but is more rapid.

The goal of treatment of GAS is to prevent acute rheumatic fever, reduce the severity and duration of symptoms, and prevent transmission.

Acute pharyngitis is generally a self-limited condition with resolution within 2 weeks. Infected individuals are not immune to reinfection with most etiologic pathogens. Treatment typically involves supportive care (e.g., analgesics) and treatment of the causative pathogen (e.g. antibiotics for GAS infections).

The only situation in which antibiotic prophylaxis to prevent GAS infections is recommended is for individuals with a history of rheumatic fever.

Acute pharyngitis is characterized by the rapid onset of sore throat and pharyngeal inflammation (with or without exudate). Absence of cough, nasal congestion, and nasal discharge suggests a bacterial, rather than viral, etiology. Acute pharyngitis can be caused by a variety of viral and bacterial pathogens, including group A Streptococcus (GAS), as well as fungal pathogens (e.g., Candida albicans). Bacterial pharyngitis, in temperate climates, is more common in winter (or early spring), while enteroviral infection is more common in the summer and fall.[1]Shulman ST, Bisno AL, Clegg HW, et al. 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. 2012 Nov 15;55(10):e86-102. http://cid.oxfordjournals.org/content/55/10/e86.long http://www.ncbi.nlm.nih.gov/pubmed/22965026?tool=bestpractice.com [2]Penn RL. Francisella tularensis. In: Mandell, GL, Bennett JE, Dolin R, eds. Principles and practice of infectious diseases. 6th ed. New York, NY: Churchill Livingstone; 2005:2674-85. Acute pharyngitis is generally a self-limited condition with resolution within 2 weeks.