Pharyngitis

BSC NURSING III YEAR

1. Mr. Manikandan.T , RN., RM., M.Sc (N)., D.C.A .,( Ph.D ) Assistant Professor, Dept. of Medical Surgical Nursing, VMCON, Puducherry . PHARYGITIS

2. DEFINITION Inflammation of the pharynx

3. Acute pharyngitis (Sore Throat): is a sudden painful inflammation of the pharynx , the back portion of the throat that includes the posterior third of the tongue, soft palate, and tonsils.

4. Causes environmental exposure to viral agents - adenovirus, influenza virus, Epstein-Barr virus, and herpes simplex virus Bacterial infection - Ten percent of adults with pharyngitis have group A beta-hemolytic streptococcus (GABHS), which is commonly referred to as group A streptococcus (GAS) or streptococcal pharyngitis . When GAS causes acute pharyngitis , the condition is known as strep throat Other bacterias - Mycoplasma pneumoniae , Neisseria gonorrhoeae , H. influenzae type B Poorly ventilated rooms, viral pharyngitis peaks during winter and early spring Viral pharyngitis spreads easily in the droplets of coughs and sneezes unclean hands that have been exposed to the contaminated fluids.

5. CLINICAL FEATURES Pain – Body, swallowing Dry cough Fever Vasodilation Edema Redness and swelling in the tonsillar pillars, uvula, and soft palate. A creamy exudate may be present in the tonsillar pillars Lymph node enlargement

6. DIAGNOSIS H.C P/E Culture Blood investigation Rapid streptococcal antigen test [RSAT]

7. Treatment Antibiotics – Doxycycline 100 mg twice daily – 5-7 days Once-daily azithromycin may be given for only 3 days due to its long half-life. A 5- or 10-day course of cephalosporin may be prescribed. Five-day administration of cefpodoxime and cefuroxime has also been successful in producing bacteriologic cures. Anti inflammatory -ibuprofen Pottasium permonganate gargles Soft, bland and warm diet

8. Nutritional Therapy A liquid or soft diet. Cool beverages, warm liquids, and flavored frozen desserts such as Popsicles are often soothing. Occasionally , the throat is so sore that liquids cannot be taken in adequate amounts by mouth. In severe situations, intravenous (IV) fluids may be needed. Otherwise, the patient is encouraged to drink as much fluid as possible (at least 2 to 3 L per day).

9. CHRONIC PHARYNGITIS Chronic pharyngitis is a persistent inflammation of the pharynx . Charecterised by multiple, white elongated keratinized epithelial outgrowths project from the surface of tonsil, base of tongue or posterior pharyngeal wall.

10. It is common in adults who work in dusty surroundings, use their voice to excess, suffer from chronic cough Habitually use alcohol and tobacco.

11. TYPES OF CHRONIC PHARYNGITIS: Hypertrophic : characterized by general thickening and congestion of the pharyngeal mucous membrane Atrophic : probably a late stage of the first type ( the membrane is thin, whitish, glistening, and at times wrinkled ) Chronic granular (“clergyman’s sore throat”), characterized by numerous swollen lymph follicles on the pharyngeal wall

12. Clinical Manifestations Foreign body sensation Constant sense of irritation or fullness in the throat, mucus that collects in the throat and can be expelled by coughing, and difficulty swallowing. A sore throat that is worse with swallowing in the absence of pharyngitis suggests the possibility of thyroiditis .

13. Medical Management Relieving symptoms- avoiding exposure to irritants, and correcting any upper Respiratory infection Nasal congestion may be relieved by short-term use of nasal sprays or medications containing ephedrine sulfate( Kondon’s Nasal) or phenylephrine hydrochloride ( Neo- Synephrine ). For allergy, one of the antihistamine decongestant medications, such as Pseudoephedrine(Sudafed ) or brompheniramine /pseudoephedrine, is prescribed orally every 4 to 6 hours. Aspirin or acetaminophen is recommended for its anti-inflammatory and analgesic properties . For adults with chronic pharyngitis , tonsillectomy is an effective option