Pathology of acute pharyngitis

2021-01-31 12:00 AM

Nonspecific pharyngitis can be localized: inflammation around the tonsils, acute tonsillitis, acute or diffuse VA, such as red pharyngitis, common white plaque pharyngitis


Acute pharyngitis is a fairly common disease that can appear separately, but is more common with the following diseases: VA inflammation, tonsillitis, rash, flu, measles, diphtheria, whooping cough, Vincent, or some blood diseases.


Acute pharyngitis is an acute inflammation of the pharyngeal mucosa (composed of an intercellular layer, mucous glands, and lymphocytes).


According to Escat's classification, acute pharyngitis is divided into 3 groups:

Nonspecific pharyngitis can be localized: inflammation around the tonsils, acute tonsillitis, acute or diffuse VA, such as: red pharyngitis, common white plaque pharyngitis.

Specific pharyngitis such as pharyngitis due to diphtheria, Vincent pharyngitis.

Sore throat in blood diseases.

Clinically often find two types: red pharyngitis and white pharyngitis (actually seen).

Red sore throat

In fact, acute inflammation of the pharyngeal mucosa or tonsils is common in the cold season, when the weather changes.


Viruses: flu, measles.

Bacteria: pneumococci, streptococci or other bacteria are readily available in the throat.

Symptoms (caused by viruses)


Starts suddenly, chills, fever high 39C- 40 0 C, headache, body aches, sleep eating ice cream.

Swollen, painful neck nodes. 


At first there is a burning sensation in the throat, thirst, gradually a burning sensation increases when swallowing and when speaking, pain spreads to the ears and a throbbing pain when swallowing.

Nasal congestion and runny nose mucus.

The voice was clear and softly husky.

Dry cough


The entire pharyngeal mucosa is red. The pharynx, anterior pillar, posterior column and posterior wall are swelling, red.

Two large inflammatory tonsils, on the surface of the tonsils have clear mucus. Sometimes there is white plaque like porridge on the surface or the mouth of the tonsils.

Laboratory tests: leukocytes in the blood do not increase.


The disease progresses in 3-4 days, if the resistance is good, the above symptoms will disappear very quickly.

If there is superinfection due to streptococci, staphylococci, complications will occur such as: ear infections, rhinitis, bronchitis inflammation.

Clinical form

Red sore throat due to influenza: into outbreaks with quite severe symptoms, headache, sore throat, bleeding in the back of the throat.

Red pharyngitis caused by APC virus (Adeno-Pharyngo-Conjunctival) in children: nasal secretion, red throat mucosa, synaptic inflammation and cervical lymphadenitis, progression of 3-5 days. 

Bacterial red sore throat: VA inflammation and tonsillitis. Can cause complications of rheumatism, acute glomerulonephritis ... neck lymph nodes are often swollen, leukocytes increase in the blood.

Drug-induced redness inflammation: seen in people allergic to some drugs, after using the drug will sore throat and nasal discharge.


Implementing the quadrants

Based on symptoms: sudden high fever, sore throat, painful swallowing.

Examination: reddened pharyngeal mucosa, pharyngeal, anterior column, posterior pillar and posterior pharynx swelling, redness. Two red congested tonsils, on the surface with clear mucus or white plaque.

Laboratory tests: leukocytes in the blood do not increase (caused by virus).

Differential diagnosis

Stage II syphilis: Red throat mucosa, but no high fever. Test for BW (+).

Drug allergic reaction: sore throat, redness. But no fever, skin erythema.


Symptom resolution is key.

Rest, keep warm.

Antipyretic: Paracetamol, Efferalgan ...

Anti-sore throat: gargle daily with warm alkaline solutions such as: salt water or BBM, children apply the throat with 5% glycerine bout.

Anti-nasal secretion: Argyron nasal drops 1% (up to 3 days).

Throat nebulizers: antibiotics and corticosteroids.

Use systemic antibiotics in case of superinfection or bacterial cause.


Do not share towels, dishes, dishes and dishes with the patient.

Small saline or diluted garlic water when around there are many people with an acute sore throat.

Tonsillectomy when inflammation recurs many times.

Common white plaque sore throat

As serious acute pharyngitis and often have complications of rheumatism, acute glomerulonephritis ... should be detected and treated promptly.


Bacterial usually by inter question, especially streptococcal haemolysis b group A saliva transmitted infections.


Body as a whole: onset is often frantic, patients with high fever 380C-390C have chills or chills, marked fatigue, and severe headache.


Sore throat: burning in the throat, burning pain in the ear. 

Mild hoarseness.


Two red, crimson tonsils, slits. A layer of white plastic covers the mouth of the slit. This base layer is creamy white first, then yellowish-Gray and is located only in the tonsils and can be cleaned with cotton without causing bleeding.

The anterior, posterior, reed, and pharynx are bloody red but not masonry.

In the back of the throat, there are several inflamed lymph islands with white basil.

Nodules in the posterior corner of the jaw are painful swelling.


Throat swab to detect bacteria: haemolytic streptococcus group B group A.

The number of leukocytes increased by over 10,000.

The blood sedimentation rate increases and Albumin may be present in the urine.


Implementing the quadrants

Rely on the onset of the disease.

Physical symptoms during pharyngeal examination (white plaque covering the surface of the tonsils).

Tests: tree streptococcal bacteria found haemolysis b group A blood test white blood increase.

Differential diagnosis

Diphtheria: usually occurs as a fluid. Pharyngeal examination often found pseudomembrane, pseudomembranous attached to the mucosa, bleeding when removed, it grows very quickly, spreading to the pillars and pharynx, pseudomembranous is insoluble in water. Diseases of infection and intoxication clearly. The cervical nodule, under the chin, are prominent and quickly. Before such a patient always swipes his throat to cultivate bacteria.

Mononucleosis: enlarged neck lymph nodes, weakness, white pharyngitis, sore throat. In the blood, mononuclear cells increased.


Antibiotic treatment progressed well, remission within 24 hours (Cephalothin, Amikacin, Gentamicin ...).


Local treatment: gargling, nebulizer.

Tonsillectomy when the disease is stable. Especially patients with Albumin in their urine.


The disease usually lasts 10 days to completely heal, if it lasts longer, it will easily cause complications in the second and third week.

Causes low heart, acute glomerulonephritis.

Perioral tonsillitis, ear infections, sinusitis, laryngitis, bronchitis.

Purulent lymphadenitis.


Inflammation around the tonsils
(see article around tonsillitis).