Acute pharyngitis

The main diseases that can be transmitted from patient to dentist and vice versa are known to be the common cold, tuberculosis, acute or chronic laryngitis, pharyngitis, acute parotitis, rubella, measles, chickenpox, hepatitis and AIDS (CDC, 1993 Brasil, 2000). 

Acute pharyngitis presents a diagnostic and therapeutic dilemma. The majority of sore throats are caused by a variety of viruses fewer than 20% are bacterial and hence potentially responsive to antibiotic therapy. However, antibiotics are widely prescribed and this reflects the difficulty in discriminating streptococcal from non-streptococcal infections clinically in the absence of microbiological documentation. Nonetheless, Strep, pyogenes is the most important bacterial pathogen and this responds to oral penicillin. However, up to 10 days treatment is required for its eradication fixm the throat. This requirement causes problems with compliance since symptomatic improvement generally occurs within 2-3 days. 

List the most common bacterial pathogens that cause acute otitis media, acute bacterial rhinosinusitis, and acute pharyngitis. 

Identify clinical signs and symptoms associated with acute otitis media, bacterial rhinosinusitis, and streptococcal pharyngitis. 

Upper respiratory tract infection (URI) is a term that refers to various upper airway infections, including otitis media, sinusitis, pharyngitis, and rhinitis. Most URIs are viral and often selflimited. Over 1 billion viral URIs occur annually in the United States, resulting in millions of physician office visits each year.1 Excessive antibiotic use for URIs has contributed to the significant development of bacterial resistance. Guidelines have been established to reduce inappropriate antibiotic use for viral URIs.2 This chapter will focus on acute otitis media, sinusitis, and pharyngitis because they are frequently caused by bacteria and require appropriate antibiotic therapy to minimize complications. 

Pharyngitis is an acute throat infection caused by viruses or bacteria. Other conditions, such as gastroesophageal reflux, postnasal drip, or allergies, also can cause sore throat and must be distinguished from infectious causes. Acute pharyngitis is responsible for 1% to 2% of adult physician visits and 6% to 8% of pediatric visits but generally is self-limited without serious sequelae.41,42 Antibiotics are prescribed in 50% to 70% of cases in adults and children because of the inability to... 

Cooper RJ, Hoffman JR, Bartlett JG, et al. Principles of appropriate antibiotic use for acute pharyngitis in adults Background. Ann Intern Med 2001 134(6) 509-517. 

Treatment with these doses of radiotherapy involves toxicity. Both acute and late effects of radiotherapy occur. Acute effects of mantle-field irradiation include nausea, vomiting, anorexia, xerostomia, dysguesia, pharyngitis, dry cough, fatigue, diarrhea,... 

Pharyngitis is an acute infection of the oropharynx or nasopharynx that results in 1% to 2% of all outpatient visits. While viral causes are most common, Group A /J-hemolytic Streptococcus, or Streptococcus pyogenes, is the primary bacterial cause. 

Nonsuppurative complications such as acute rheumatic fever, acute glomerulonephritis, and reactive arthritis may occur as a result of pharyngitis with Group A Streptococcus. 

Clinical signs in humans and animals related to acute toxic exposure to 1,2-dibromoethane are depression and collapse, indicative of neurologic effects, and erythema and necrosis of tissue at the point of contact (oral and pharyngeal ulcers for ingestion, skin blisters and sloughing for dermal exposure). Neurologic signs are not seen in animals exposed to nonlethal doses. 

Exposure to levels above 50 ppm for 1 hour can produce acute conjunctivitis with pain, lacrimation, and photophobia in severe form, this can progress to keratoconjunctivitis and vesiculation of the corneal epithelium. Prolonged exposure to 50 ppm also causes rhinitis, pharyngitis, bronchitis, and pneumonitis. 

Upper respiratory tract Acute otitis media-Acute maxillary sinusitis Pharyngitis/Tonsillitis... 

Azithromycin Safety and efficacy in children younger than 6 months of age (acute otitis media, community-acquired pneumonia) or younger than 2 years of age (pharyngitis/tonsillitis) have not been established. 

Cefditoren (Spectrac ) [Antibiotic/Cephalosporin-3rd Generation] Uses Acute exacCTbations of chronic bronchitis, pharyngitis, tonsillitis skin Infxns Action 3rd-gen cqjhalosporin -I- ceU wall S5mth Dose Adults Feds >12 y Skin 200 mg PO bid X 10 d Chronic bronchitis, pharyngitis, tonsillitis 400 mg PO bid X 10 d avoid antacids w/in 2 h take w/ meals X in renal impair Caution [B, ] Renal/hqiatic impair Contra C halosporin/PCN allergy, milk protein, or carnitine deficiency Disp Tabs SE HA, N/V/D, cohtis, nephrotox. 

As most acute upper respiratory tract infections are not of bacterial origin, antibiotics are not often necessary in cases of acute pharyngitis and sinusitis. Supportive measures such as aerosols or rinsing with sterile saline and antipyretics are often sufficient. 

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