Pharyngitis

Acute Pharangitis
It may be an accompanying feature of many local and systemic diseases e.g. Acute attack of common cold or feature of other infections like measles, chicken pox or influenza. May also develop after trauma or after instrumentation.
The chief symptom is sore throat, associated with fever or other constitutional symptoms. Examination reveals diffuse congestion of the pharyngeal wall, uvula and adjacent faucial tissues. Oedema of the lining mucosa and uvula and enlargement of the glands of the neck may be present.
Treatment consists of bed rest, analgesics and antibiotics preferably erythromycin.

Membranous Pharyngitis
Various diseases local or systemic are associated with membrane formation in the pharynx.
Faucial diphtheria: The condition is caused by Corynebacterium diptheriae. The membrane is greyish white and extends to the uvula and soft palate. It cannot be easily removed and on removal leaves a raw bleeding surface. There occurs marked toxaemia associated with a fast pulse rate, disproportionate to the rise in temperature.
Treatment: Diptheria antitoxin along with erythromycin/penicillin.
Vincent’s Angina:

This condition is characterised by an ulcerative lesion on the tonsils, usually on one side. The lesions are covered by slough, which may extend to the adjacent pharyngeal tissues and gums. Low grade fever and malaise are accompanying features. There occurs characteristically fishy odour.
Treatment is by administering penicillin or erythromycin in addition to analgesics and mouth washes.
Agranulocytosis:

It occurs as a result of sensitivity to drugs like sulphonamide, chloramphenicol, cytotoxic drugs. The symptoms are sore throat, ulcerations in the buccopharyngeal mucosa and false membrane formation. Diagnosis is confirmed by the blood picture which shows marked reduction in neutrophils.
Treatment is withdrawal of the drugs.
Leukemia:

Acute lymphocytic leukemia may sometimes present as oropharyngeal ulcerations with membrane formation. Diagnosis is by blood picture.
Infectious Mononucleosis:

It is viral disease which may sometimes be associated with oral lesions. The uvula may be swollen and there may occur inflammatory lesions in other part of buccopharyngeal mucosa. The blood picture shows leucocytosis and relative increase in lymphocytosis. The Paul-Bunnel test is positive.
Moniliasis (Thrush)

It is a fungal infection of the mouth due to candida albicans. The lesions appear as white or greyish whit patches on the oropharyngeal mucosa surrounded by areas of slight redness.
Treatment consists of local application of nystatin in glycerine.

Chronic Pharyngitis:

Chronic inflammation of the pharynx may be non-specific or specific.
Chronic non-specific Pharyngitis: Various aetiological factors in the nose or oral cavity may produce secondary effects in the pharynx. The most constant symptom is discomfort in the throat with a foreign body sensation. Spasms of cough and tendency to clear throat are common. Tiredness of voice and difficulty in swallowing may occur. Diffuse congestion of the pharyngeal wall may be seen and prominent vessels are seen through the inflamed mucosa.
Treatment: It is difficult to reverse the chronic changes once they have set in. However, symptoms can be alleviated to a great extent. Cough suppressants like codeine phosphate linctus and local application of various soothing paints like Mandl’s paint is of help. Alcohol, smoking, irritants and spicy foods should be avoided.