Pharyngitis – acute or chronic inflammation of the mucous membrane of the pharynx, which is accompanied by pain, discomfort or a tickling in the throat buy zithromax online.
As with an anatomical point of view of the pharynx is divided into three sections – the upper (nasopharynx), medium (oropharynx) and lower (hypopharynx), inflammatory processes developing here can also be classified according to their predominant localization. However, this division is rather conventional, especially in acute pharyngitis, due to the fact that acute viral and bacterial infections affect diffusely mucosa of the upper respiratory tract and are migratory, often descending character. Morphological changes in the mucosa of chronic pharyngitis usually have a preferential localization in one of the anatomical parts of the throat that makes some degree of conditionality allocate nosology, for example, chronic nasopharyngitis.
Causes of pharyngitis
The main cause of pharyngitis – a cold or inhalation of contaminated air, the effect of chemical stimuli (alcohol, tobacco). Infectious pharyngitis can be triggered by a variety of microbes (streptococci, staphylo-, pneumococci, as well as viruses (influenza, adenovirus) and fungi (Candida). Often, pharyngitis develops as a result of infection from any source of inflammation adjacent to the throat. So developing pharyngitis sinusitis, rhinitis, dental caries.
By etiological factor of acute pharyngitis can be divided into viral, bacterial, fungal, allergic, traumatic (a consequence of getting a foreign body or surgery) and caused by exposure to irritants (hot liquid or steam, acids, alkalis, irradiation, etc.). Chronic pharyngitis is generally classified not on the etiological basis and the nature of developing in the mucosa changes: catarrhal (simple), atrophic (subatrophic) and hypertrophic. These forms of chronic inflammation are often combined. Thus, the presence of diffuse atrophic changes in the mucosa may be associated with focal hyperplasia of the lymphoid tissue of the rear wall of the pharynx or tubofaringealnyh rollers.
The most common form of the pharyngeal mucosa of acute inflammation is catarrhal pharyngitis with SARS. It is known that about 70% of pharyngitis caused by viruses, including rhinovirus mark, coronaviruses, respiratory syncytial virus, adenovirus, influenza and parainfluenza viruses. The most common causative agent of acute pharyngitis are rhinoviruses. Studies in recent years show that their importance is growing rapidly, and now the rhinoviruses responsible for more than 80% of cases of acute respiratory viral infections during the period of autumn epidemics. Viral infection is often only the first phase of the disease, and it “paves the way” for the subsequent bacterial infection.
The symptoms of pharyngitis
For the clinical picture of acute pharyngitis is characterized by a tickle, dryness, discomfort and pain in the throat when swallowing (especially when empty throat), at least – malaise, temperature rise. When inflammation tubofaringealnyh rollers pain usually radiates to the ears. On palpation may experience soreness and increase upper cervical lymph nodes. When pharyngoscope visible redness of the posterior pharyngeal wall and palatine arches, some inflamed lymphoid granules, but no characteristic signs of tonsillitis inflammation of the tonsils. Remember that strep throat can be the first manifestation of some infectious diseases: measles, scarlet fever, measles, rubella. In some cases, it requires a differential diagnosis of the disease Kavasaki syndrome and Stevens-Johnson.
For the clinical picture of chronic pharyngitis is not characterized by an increase in temperature and a significant deterioration in the general condition. Feeling sick characterized as dry, tickling and sensation of a lump in the throat that makes you want to cough or “clear his throat.” The cough is usually persistent, dry and easily distinguishable from coughing that accompanies for tracheobronchitis. Discomfort in the throat is often associated with the need to constantly forced to swallow from the back of the throat mucus, which makes patients irritable, it interferes with their normal activities and disrupts sleep.
In atrophic pharyngitis pharyngeal mucosa looks thinning, dry, often covered with dried mucus. On the shiny surface of the mucosa can be seen injected vessels. In hypertrophic form pharyngoscope reveals foci hyperplastic lymphoid tissue, randomly scattered on the back of the throat or enlarged tubofaringealnye rollers located behind the rear palatal arches. At the time of exacerbation these changes are accompanied by hyperemia and edema of the mucosa, but usually the scarcity of objective findings do not correspond to the severity of symptoms, disturbing patients.
Chronic pharyngitis is often not an independent disease, but a manifestation of the pathology of the gastrointestinal tract: chronic atrophic gastritis, cholecystitis, pancreatitis. Contact with acidic stomach contents into the throat during sleep with gastroesophageal reflux disease and hiatal hernia is often the underlying cause of chronic catarrhal pharyngitis, and in this case, without addressing the underlying cause of the disease, any methods of local treatment failure and provide short-term effect. Smoking and tonsillectomy lead to the development of atrophic changes in the mucosa of the pharynx.
Pharyngitis often develops in constant difficulty in nasal breathing. It can be caused not only by the transition to breathing through the mouth, but also the abuse of vasoconstrictor drops that flow down from the nasal cavity into the pharynx and have it unnecessary anemiziruyuschy effect. The symptoms of pharyngitis may be present at the so-called postnasal syndrome (English term – «postnasal drip»). In this case, the discomfort in the throat associated with runoff pathological secretion from the nasal cavity or paranasal sinuses on the back of the throat. In addition to the constant coughing can cause this condition in children the appearance of wheezing, which requires differential diagnosis with asthma.