Acute Pharyngitis

Acute Pharyngitis

Acute pharyngitis is an inflammatory process of the oropharynx, primarily caused by infections. Upper respiratory tract infections are the most common reason patients seek medical care. In the United States each year, more than 10 million patients are diagnosed with acute pharyngitis. Viruses account for well over half of these cases. Several species of bacteria are also capable of causing acute pharyngitis and of these, group A Streptococcus (GAS) is the most common and important.

The significance of streptococcal pharyngitis relates to its acute morbidity, occasional suppurative complications, and infrequent nonsuppurative sequelae of rheumatic fever and poststreptococcal glomerulonephritis. GAS is the only commonly occurring form of acute pharyngitis for which antibiotic therapy is indicated.

Appropriate antibiotic treatment of GAS pharyngitis leads to more rapid resolution of symptoms and helps prevent rheumatic fever. On the other hand, antibiotic treatment of acute pharyngitis caused by organisms other than GAS is of negligible clinical value, exposes patients to the risk of complications from antibiotic therapy, and promotes emergence of antibiotic resistant bacteria.

Therefore, the pertinent clinical issue in the evaluation of patients with acute pharyngitis is the differentiation of GAS infection from other causes. This article primarily focuses on GAS pharyngitis and concludes with a brief discussion of other causes of bacterial pharyngitis.