Sore throat

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Sore throat is the general term used for a condition wherein a person experiences difficulty in ingesting or swallowing due to inflammation of the throat. The term is then used to be more specific.

Contents

Types of sore throat

  • Pharyngitis. It is the pain and inflammation of the pharynx. The pharynx is the area of the throat behind the mouth and the soft palate.
  • Tonsillitis. It is the inflammation of the tonsils, which are located at the back and sides of the throat. This causes difficulty in swallowing, and on worse cases, may cause difficulty of breathing. Recurring tonsillitis may lead to the development of rheumatic heart disease.
  • Laryngitis. It is the pain and inflammation of the larynx or windpipe which is usually manifested by hoarseness of the voice. The larynx allows passage of air to and from the lungs but blocks the entry of solid and liquid food. If the larynx fails to do this, substances will go to the lungs and cause aspiration. Aside from this significant function, the larynx also produces sound at the vocal cords.
  • Epiglottitis. It is the inflammation of the epiglottis or the flap of cartilage located in the throat behind the tongue and in front of the larynx. The epiglottis is usually upright at rest allowing air to pass into the larynx and lungs. This condition is very rare.

Symptoms

  • A systemic sore throat may manifest symptoms such as fever, headache, nausea and malaise. Viral or bacterial infection is possible.
  • Dysphagia or pain during swallowing is present in pharyngitis and tonsillitis. Hoarseness of voice is evident for a person with laryngitis.

Signs

  • If bacterial or viral infection is involved, there is a possibility that pus may be seen on the surface of the tonsils.
  • Upon inspection of the pharynx, redness may be seen on the oropharynx (the viewable part of the pharynx).
  • If the neck glands are palpated, tenderness can be noted. This is due to the inflammation of the lymph nodes.
  • If dysphagia becomes severe, drooling and spitting is manifested.
  • Difficulty of breathing happens especially when the passage through the pharynx or larynx for air is too narrow

Causes

  • Viruses and bacteria
  • As a side effect or complication of medical interventions such as tonsillectomy, an airway management during a surgical procedure, chemotherapy, or radiation
  • Chemicals such as cigarette smoke
  • Injuries of the throat (abrasion from a bone fragment)
  • Allergies or postnasal drip
  • Cancer (rare)

Risk factors

  • Age. Children and teenagers are susceptible to sore throat. Children commonly develop strep throat, a bacterial infection caused by streptococcus.
  • Tobacco. Irritation of the throat because of smoke and second hand smoke increases the risk for developing sore throat. Aside from this, the use of tobacco increases the risk of a person to develop cancers of the mouth, throat, and larynx.
  • Allergies. A person who has seasonal or non-seasonal allergies to cold, dust, or animal dander is more likely to develop sore throat than people who do not have allergies.
  • Exposure to chemical irritants. Strong chemicals emitted from burning fossil fuels and common household chemicals can cause throat irritation.
  • Lowered immunity. A person who has weak immune system is susceptible to. Immunocompromised people are those who have HIV/AIDS, diabetes, those who are undergoing treatments with steroids or chemotherapy drugs, those under stress, and those who have poor diet.

Diagnosis and tests

Physical examination is done by a health practitioner. This includes taking of the medical history, inspection of the throat, ears and nasal passages, palpation of the neck to check for swollen lymph nodes and listening to the breath sounds by using a stethoscope.

A throat swab is done to check for bacterial infection. It is done by rubbing a sterile swab over the back of the throat to get a sample of secretions. The specimen is sent to the laboratory for analysis. If the result of the test is positive, it is likely that the sore throat is caused by a bacterial infection. However, if the result turns out to be negative, the sore throat may be caused by a viral infection.

Treatment

In case of viral infection, medical or pharmacological intervention is not needed. A viral infection usually lasts from five to seven days. However, if the sore throat is caused by a bacterial infection, a full course of antibiotic therapy is needed.

Possible complications

An untreated and recurring sore throat, especially tonsillitis, may lead to the development of rheumatic heart disease. The bacteria affecting the tonsils may go to the mitral valve of the heart and eventually cause rheumatic heart disease.

Sore throat may also lead to a complication called post-streptococcal glomerulonephritis. Moreover, other complications may be ear infections, sinusitis, mastoiditis, peritonsillar abscess and scarlet fever.

Prevention and control

Avoiding people with illnesses is the best way to prevent sore throat, since one can develop colds because of the viruses. People with sore throat can spread the disease especially when they are not yet under antibiotic treatment. They should avoid crowded places and should stay at home for at least a day or two. Hygiene can also help in preventing the spread of the disease.

Cases in the Philippines

Sore throat is common in the Philippines especially in the children. During the rainy season, the number of cases of sore throat also increases as this is the season where colds are inevitable.

In 2009, when the AH1N1 threat entered the Philippines, having a sore throat increased anxiety among people. During an AH1N1 outbreak, persons who develop sore throat with cough and fever are isolated and will have to undergo a special throat swab to confirm AH1N1.

References