PATHOPHYSIOLOGY OF PHARYNGITIS

BACTERIA
VIRUS
Invasion of mucosa

Local Inflammation

Irritation of mucosa by secretions

Release of toxins and proteases

M-protein fragments of GABHS and sarcolemma antigens of myocardium

Antigen-antibodies complex in glomeruli

Produce the Signs and Symptoms

Younger Child Older Child

• Fever • Fever may reach 40℃
• General malaise • Headache
• Anorexia • Anorexia
• Moderate sore throat • Vomiting
• Headache • Mild to fiery red edematous pharynx
• Mild to moderate hyperemia • Hyperemia of tonsils and pharynx;
• Abdominal pain may extend to soft palate and uvula
• Often abundant follicular exudate
that spreads and coalesces to form
pseudomembrane on tonsils
• Cervical glands enlarged and
tender

Therapeutic Management Diagnostic Evaluation

▪ Oral Penicillin V or Amoxicillin ▪ Throat culture

▪ IM Benthazine Penicillin G
▪ Cephalosporins, clindamycin and
Amoxicillin with clavulanic acid
Risk for:
▪ Oral macrolide (erythromycin,
azithromycin and clarithromycin)
Take this if the physician prescribed
▪ Rapid Streptococcal Antigen
▪ Rheumatic fever
▪ Inflammatory disease of the heart, joints
and CNS
▪ Acute glomerulonephritis
▪ Acute kidney infection
▪ Skin manifestation including impetigo
and pyoderma