Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Systems
- 1 Infective Endocarditis
- 2 Myocarditis and Pericarditis
- 3 Dental and Odontogenic Infections
- 4 Systemic Diseases Causing Fever and Rash
- 5 Otitis Media
- 6 Otitis Externa
- 7 Sinusitis
- 8 Supraglottitis
- 9 Pharyngitis and Tonsillitis
- 10 Deep Neck Space Infections
- 11 Mumps
- 12 Peritonitis
- 13 Viral Hepatitis
- 14 Infectious Biliary Diseases: Cholecystitis and Cholangitis
- 15 Acute Infectious Diarrhea
- 16 Diarrhea in HIV-Infected Patients
- 17 Ulcerative Sexually Transmitted Diseases
- 18 Nonulcerative Sexually Transmitted Diseases
- 19 Vulvovaginitis
- 20 Male Genitourinary Infections
- 21 Adult Septic Arthritis
- 22 Hand Infections: Fight Bite, Purulent Tenosynovitis, Felon, and Paronychia
- 23 Osteomyelitis
- 24 Open Fractures
- 25 Spinal Infections
- 26 Prosthetic Joint Infections
- 27 Diabetic Foot Infections
- 28 Plantar Puncture Wounds
- 29 Periocular Infections
- 30 Conjunctival and Corneal Infections
- 31 Uvea, Vitreous, and Retina Infections
- 32 Community-Acquired Pneumonia
- 33 Tuberculosis
- 34 Influenza
- 35 HIV-Associated Respiratory Infections
- 36 Arthritis in the Acute Care Setting
- 37 Lower Urinary Tract Infection in Adults
- 38 Pyelonephritis in Adults
- 39 Fever and Headache: Meningitis and Encephalitis
- 40 Fever and Focal Cerebral Dysfunction
- 41 Fever and Acute Weakness Localizing to the Spinal Cord
- 42 Altered Mental Status in HIV-Infected Patients
- 43 Bacterial Skin and Soft-Tissue Infections
- Part II Pediatrics
- Part III Special Populations
- Part IV Current Topics
- Part V Overview of Antibiotics
- Part VI Microbiology/Laboratory Tests
- Part VII Infection Control Precautions
- Index
- References
9 - Pharyngitis and Tonsillitis
from Part I - Systems
Published online by Cambridge University Press: 15 December 2009
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Systems
- 1 Infective Endocarditis
- 2 Myocarditis and Pericarditis
- 3 Dental and Odontogenic Infections
- 4 Systemic Diseases Causing Fever and Rash
- 5 Otitis Media
- 6 Otitis Externa
- 7 Sinusitis
- 8 Supraglottitis
- 9 Pharyngitis and Tonsillitis
- 10 Deep Neck Space Infections
- 11 Mumps
- 12 Peritonitis
- 13 Viral Hepatitis
- 14 Infectious Biliary Diseases: Cholecystitis and Cholangitis
- 15 Acute Infectious Diarrhea
- 16 Diarrhea in HIV-Infected Patients
- 17 Ulcerative Sexually Transmitted Diseases
- 18 Nonulcerative Sexually Transmitted Diseases
- 19 Vulvovaginitis
- 20 Male Genitourinary Infections
- 21 Adult Septic Arthritis
- 22 Hand Infections: Fight Bite, Purulent Tenosynovitis, Felon, and Paronychia
- 23 Osteomyelitis
- 24 Open Fractures
- 25 Spinal Infections
- 26 Prosthetic Joint Infections
- 27 Diabetic Foot Infections
- 28 Plantar Puncture Wounds
- 29 Periocular Infections
- 30 Conjunctival and Corneal Infections
- 31 Uvea, Vitreous, and Retina Infections
- 32 Community-Acquired Pneumonia
- 33 Tuberculosis
- 34 Influenza
- 35 HIV-Associated Respiratory Infections
- 36 Arthritis in the Acute Care Setting
- 37 Lower Urinary Tract Infection in Adults
- 38 Pyelonephritis in Adults
- 39 Fever and Headache: Meningitis and Encephalitis
- 40 Fever and Focal Cerebral Dysfunction
- 41 Fever and Acute Weakness Localizing to the Spinal Cord
- 42 Altered Mental Status in HIV-Infected Patients
- 43 Bacterial Skin and Soft-Tissue Infections
- Part II Pediatrics
- Part III Special Populations
- Part IV Current Topics
- Part V Overview of Antibiotics
- Part VI Microbiology/Laboratory Tests
- Part VII Infection Control Precautions
- Index
- References
Summary
INTRODUCTION – AGENTS
Pharyngitis and tonsillitis both are most frequently caused by Streptococcus pyogenes (group A beta-hemolytic streptococcus). However, many other organisms have been cultured in pharyngitis and tonsillitis, including viridans group Streptococci, Staphylococcus aureus, and Haemophilus influenzae. Oral flora such as Actinomyces can also be a bacterial etiology. It is not uncommon for the infection to be caused by a mix of aerobic and anaerobic flora.
Viruses with a predilection for the upper respiratory tract can also be causative and are, in fact, more prevalent. These include rhinoviruses, influenza viruses, adenovirus, enteroviruses, reovirus, respiratory syncytial virus, parainfluenza viruses, and coronaviruses. Infection with the Epstein-Barr virus (EBV) is common and may be accompanied by extensive tonsillar exudates. Other etiologies include toxoplasmosis, candida, tularemia, and cytomegalovirus.
EPIDEMIOLOGY
Pharyngitis and tonsillitis are most commonly seen in children and teenagers (though rarely in children under 2), and are not unusual in adults. In general, it is more likely for children than for adults to have a bacterial etiology of a sore throat. There is a peak incidence in Streptococcus pharyngitis from November to May.
CLINICAL FEATURES
Pharyngitis and tonsillitis both present with dysphagia, odynophagia, and a low-grade fever (Table 9.1). There may be erythema of the pharynx. In a tonsillar infection in which the many crevices (or crypts) harbor bacterial infection, patients may complain of bad breath and foul-tasting whitish lumps on the tonsils.
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- Information
- Emergency Management of Infectious Diseases , pp. 45 - 46Publisher: Cambridge University PressPrint publication year: 2008