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Pharyngitis Soheila Abachi Summer 2014

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Definition

Pharyngitis refers to inflammation of pharynx.

tonsils are most often affected

pharyngitis, tonsillitis, tonsillopharyngitis &

pharyngotonsillitis are used interchangeably

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Causes

Up to 85% are caused by viruses

most common bacterial pharyngitis caused

by Streptococcus pyogenes

Streptococcus pyogenes , Group A- Beta

haemolytic streptococci (GAβHS) gram

positive, catalase negative, facultative

anaerobe, occurs in pairs or chains

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GAβHS represent one of most impressive human

pathogens, it cause a wide array of serious infections

including:PharyngitisSkin infection (impetigo, erysipelas)Respiratory infectionEndocarditisMeningitisPuerperal sepsisArthritisScarlet fever

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Public health importance

It is a precursor of two serious non-suppurative sequlae;

acute rheumatic fever & heart diseases

“inflammatory disease mediated by autoimmune”

mechanisms

post streptococcal glomerulonephritis

“renal diseases, usually affecting both kidneys”

GABHS RHDARF GN

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Risk factors

GAHBS diseases are most common in setting

overcrowding, where living conditions promote

transmission of organism

It affects school–age children, particularly

those 5-11 years old

Streptococcal pharyngitis most often occurs in

the late winter and early spring

children & adults of all ages can be infected

with group A streptococci

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Mode of transmission of GAHBS

GAβHS spread when a person coughs

or sneezes infected large droplets that

come into contact with another

person’s mucous membrane. The

highest risk of transmission occurs

during the acute stage.

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GAβHS pharyngitis in some developed countries:

Acute pharyngitis is one of the most common illnesses

for which patients seek medical advice in the more

developed countries. accounting for nearly over 7 million

visits to pediatricians each year in the United States. In this

country.

Oliver (2000) in England reported that the prevalence of

GAβHS was 20%.

In France, Chiadmi et al (2003) stated that the

prevalence was 33%.

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In Belgium, sore-throat is one of the most frequent

causes of consultation seen by general practitioner, and

GAS has been isolated in 20.3% of cases.

In Chile, a study done by Munoz et al (2003-2004),

streptococcus sore-throats were detected in 37% of cases.

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Clinical presentations

Diagnosis of streptococcal pharyngitis

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Phytochemicals effective against GAS

Armenian plum (Prunus armeniaca) Clove (Syzygium aromaticum)

Bitter kola (Garcinia Kola) Ginger (Zingiber Officinale)

Blue gum (Eucalyptus globulus) Holm oak (Quercus ilex)

Bush-banana (Uvaria chamae) Little gourd (Coccinia grandis)

Calabash tree (Crescentia cujete) Para cress (Acmella oleracea)

Chayote (Sechium edule) Thyme (Thymus vulgaris)

Chili pepper (Capsicum chinense) White weed (Ageratum conyzoides)

Cinnamon (Cinnamomum zeylanicum) Wild maracuja (Passiflora foetida)

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Folklore medicine for S. pyogenes

infections

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Acute sore throat, chronic nasopharyngeal catarrh

Gargle of Stickwort (Agrimony)

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Sore throat

Infusion, gargle of bark, leaves of Cashew plant (Anacardium occidentale)

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Sore throat

Extracts of Bush-banana (Uvaria chamae)

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Sore throat, cold

Infusion, gargle of Bayberry (Myrica cerifera)

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Erysipelas, pharyngitis, upper respiratory

Tea of flowers, Soft leafed Honeysuckle (Lonicera confuse)