Upper Respiratory Tract Infections - Acute Pharyngitis

Question 1

Most common pathogens that cause acute pharyngitis

Answer 1

-Rhinovirus
-Coronavirus
-Adenovirus
-Strep. pyogenes (group A)

Question 2

Complications that can occur from a bacterial acute pharyngitis

Answer 2

-Rheumatic fever (inflammation of the hear, blood vessels or joints)
-Glomerulonephritis (inflammation of the glomeruli)
-Peritonsillar or retropharyngeal abscess (pus in the back of the throat)
-Mastoiditis (infection of the mastoid bone)
-Otitis media (ear infection)
-Rhinosinusitis (inflammation of the nasal passages)

Question 3

Clinical presentation of acute pharyngitis

Answer 3

-Sudden onset of sore throat with dysphagia and fever
-Pharyngeal hyperemia and tonsillar swelling (may have exudates)
-Enlarged, tender lymph nodes
-Red, swollen uvula
-Petechiae on soft palate

Question 4

What testing is done for acute pharyngitis?

Answer 4

-Historically, culture of the throat was the diagnostic standard
-Rapid antigen detection tests (RADT) have gained popularity (standard of care)
-Do a RADT first and if it comes back negative, do a throat culture or PCR-based test

Question 5

Drugs of choice for treatment of acute pharyngitis

Answer 5

-Penicillin VK 250 mg PO TID, QID or 500 mg PO BID
-Amoxicillin 500 mg PO TID or 875 mg PO BID

Question 6

How long is treatment for acute pharyngitis?

Answer 6

10 days

Question 7

Alternative treatment for acute pharyngitis in patients with a non-anaphylactic reaction to penicillin

Answer 7

-Cephalexin 500 mg PO BID
-Cefadroxil 500 mg PO BID or 1 gram PO once daily
-Cefuroxime 500 mg PO BID
-Cefpodoxime 200 mg PO BID

Question 8

Alternative treatment for acute pharyngitis in patients with an anaphylactic reaction to penicillin

Answer 8

-Azithromycin 500 mg PO on day 1, then 250 mg PO daily on days 2-5
-Clindamycin 300 mg PO TID (dude hates this drug)