Pharyngitis Causes

Aka: Pharyngitis Causes, Sore Throat Causes

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II. Causes: Bacterial (Persists slightly longer than viral)

  1. Common Bacterial Causes
    1. Group A Streptococcal Pharyngitis
    2. Pneumococcus
    3. Staphylococcus Aureus (also Bacterial Tracheitis)
    4. Haemophilus Influenzae (also Epiglottitis)
    5. Moraxella catarrhalis
  2. Other Bacterial Causes
    1. Fusobacterium necrophorium (Fusobacterium Pharyngitis)
      1. Causes 10% of Pharyngitis cases in young adults and adolescents
      2. Risk of Lemierre Syndrome (high morbidity and mortality)
      3. Consider empiric treatment in young patients with severe, prolonged cases >5 days
    2. Other Streptococcal species (Groups B, C, G)
    3. Neisseria gonorrhoeae
    4. Chlamydia pneumoniae
    5. Klebsiella
    6. Moraxella
    7. Mycoplasma
    8. Corynebacterium diphtheriae
    9. Mycobacterium
  3. Rare Bacterial Causes
    1. Tularemia
    2. Arcanobacterium haemolyticum
    3. Prevotella intermedia
  4. General Bacterial processes
    1. Tonsillitis
    2. Ludwig's Angina

III. Causes: Viral (Pharyngitis lasts 5-7 days)

  1. Common Causes
    1. Rhinovirus (Spring and fall, mild Symptoms)
    2. Coronavirus (Winter, mild Symptoms)
  2. Other Causes
    1. Adenovirus (Moderate Symptoms, Conjunctivitis)
    2. Influenza (Epidemics)
    3. Parainfluenza (Types 1-4)
    4. Epstein-Barr Virus (EBV, Mononucleosis)
    5. Coxsackievirus
    6. Cytomegalovirus (CMV, Mononucleosis-Like Syndrome)
    7. Herpes Simplex Virus (HSV) Stomatitis
    8. Acute HIV Infection (Acute Retroviral Syndrome)
    9. Respiratory Syncytial Virus (RSV)
    10. Myxovirus
    11. Reovirus
    12. Enteric virus
    13. Mumps
    14. Rabies

IV. Causes: Fungal

  1. Common Causes
    1. Candida albicans
  2. Other Causes
    1. Rhinosporidium
    2. Cryptococcus
    3. Histoplasma
    4. Blastomyces
    5. Paracoccidioides

V. Causes: Nasal and paranasal Disease

  1. Allergic Rhinitis
  2. Sinusitis

VI. Causes: Malignancy

  1. Adenocarcinoma
  2. Leukemia
  3. Lymphoma
  4. Sarcoma
  5. Squamous Cell Carcinoma

VII. Causes: Autoimmune and Allergic Conditions

  1. Behcet's Syndrome
  2. Reiter's Syndrome
  3. Kawasaki's Disease
  4. Erythema Multiforme Major (Stevens-Johnson Syndrome)
  5. Pemphigus
  6. Angioedema

VIII. Causes: Miscellaneous

  1. Trauma
    1. Accidents
    2. Child Abuse
    3. Structure fire or smoke exposure
    4. Post-procedure (e.g. Bronchoscopy, Endoscopy or Endotracheal Intubation)
  2. Chemical Burns
    1. Caustic Ingestion
    2. Medication related (e.g. Aspirin)
  3. Thermal Injury (Hot foods or liquids)
  4. Contact Stomatitis
  5. Mouth breathing
  6. Vocal cord Granuloma
  7. Toxins
    1. Cigarette or Marijuana smoke
    2. Smog or environmental pollutants
    3. Snorting or sniffing other illicit substances
  8. Gastroesophageal Reflux (Heartburn)
    1. Laryngopharyngeal reflux

IX. References

  1. Anderson (2019) Crit Dec Emerg Med 33(9): 3-10
  2. Degowin (1987) Diagnostic Exam p. 149-151
  3. Gwaltney in Mandell (2000) Infectious Dis, p. 656-61
  4. Vincent (2004) Am Fam Physician 69(6):1465-70 [PubMed]

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