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Pharyngitis ( Sore Throat) Viral versus Bacterial Pharyngitis

By: Leonard Einstein , APRN, NP-C, FNP-BC

Board Certified Nurse Practitioner


๐‘ฉ๐’‚๐’„๐’•๐’†๐’“๐’Š๐’‚๐’ ๐’๐’“ ๐‘ฝ๐’Š๐’“๐’‚๐’ ?


๐‘จ๐’๐’•๐’Š๐’ƒ๐’Š๐’๐’•๐’Š๐’„๐’” ? ๐‘ถ๐’“ ๐’”๐’–๐’‘๐’‘๐’๐’“๐’•๐’Š๐’—๐’† ๐’•๐’“๐’†๐’‚๐’•๐’Ž๐’†๐’๐’• ๐’๐’๐’๐’š ?


Although the cause is usually viral it can also be bacterial; differentiating between Bacterial and viral is extremely important since Bacterial pharyngitis cannot be cured at home and it requires a visit to the medical office and treatment with antibiotics.


A common presentation of ๐‘ฉ๐’‚๐’„๐’•๐’†๐’“๐’Š๐’‚๐’ ๐‘ท๐’‰๐’‚๐’“๐’š๐’๐’ˆ๐’Š๐’•๐’Š๐’”


* acute-onset ๐‘บ๐’๐’“๐’† ๐‘ป๐’‰๐’“๐’๐’‚๐’• with ๐‘ป๐’๐’๐’”๐’Š๐’๐’‚๐’“ ๐’†๐’™๐’–๐’…๐’‚๐’•๐’†๐’” (*MAJORILY Bacterial )

* ๐‘ญ๐’†๐’—๐’†๐’“ (Bacterial) , ๐‘ฏ๐’†๐’‚๐’…๐’‚๐’„๐’‰๐’†๐’”

* ๐‘ฌ๐’๐’๐’‚๐’“๐’ˆ๐’†๐’… /๐’•๐’†๐’๐’…๐’†๐’“ ๐’„๐’†๐’“๐’—๐’Š๐’„๐’‚๐’ ๐’๐’๐’…๐’†๐’”

* ๐‘จ๐’ƒ๐’”๐’†๐’๐’”๐’† ๐’๐’‡ ๐‘ช๐’๐’–๐’ˆ๐’‰ ๐’‚๐’๐’… ๐’‚๐’ƒ๐’”๐’†๐’๐’„๐’† ๐’๐’‡ ๐‘บ๐’•๐’–๐’‡๐’‡๐’š ๐’๐’๐’”๐’† *(Bacterial indicator)

* ๐‘ด๐’‚๐’š ๐’‰๐’‚๐’—๐’† ๐’”๐’‚๐’๐’…๐’‘๐’‚๐’‘๐’†๐’“ ๐’“๐’‚๐’”๐’‰ ๐’๐’ ๐’•๐’๐’“๐’”๐’ ๐’๐’“ ๐’‘๐’†๐’•๐’†๐’„๐’‰๐’Š๐’‚๐’† ๐’๐’‡ ๐’”๐’๐’‡๐’• ๐’‘๐’‚๐’๐’‚๐’•๐’† (๐‘ต๐‘ถ ๐‘จ๐‘ณ๐‘พ๐‘จ๐’€๐‘บ)




A common presentation of viral pharyngitis

* Sore throat

* ๐‘ช๐’๐’“๐’š๐’›๐’‚ ( Only present in Viral)

* ๐‘ช๐’๐’๐’‹๐’–๐’๐’„๐’•๐’Š๐’—๐’Š๐’•๐’Š๐’” (๐‘ด๐’‚๐’‹๐’๐’“๐’Š๐’๐’š ๐‘ฝ๐’Š๐’“๐’‚๐’ )

* ๐‘ช๐’๐’–๐’ˆ๐’‰ ๐’‚๐’๐’… ๐’‰๐’๐’‚๐’“๐’”๐’†๐’๐’†๐’”๐’” ( ๐‘ด๐’‚๐’‹๐’๐’“๐’Š๐’๐’š ๐‘ฝ๐’Š๐’“๐’‚๐’)

* May also have malaise (๐ญ๐ข๐ซ๐ž๐๐ง๐ž๐ฌ๐ฌ) , myalgia (๐—บ๐ฎ๐ฌ๐œ๐ฅ๐ž ๐ฉ๐š๐ข๐ง) , anorexia (๐ฅ๐š๐œ๐ค ๐—ผ๐Ÿ ๐š๐ฉ๐ฉ๐ž๐ญ๐ข๐ญ๐ž) , difficulty swallowing (๐๐ฒ๐ฌ๐ฉ๐ก๐š๐ ๐ข๐š)






How to differentiate Viral from Bacterial?


In the office


* ๐‘น๐’‚๐’‘๐’Š๐’… ๐‘บ๐’•๐’“๐’†๐’‘๐’• ๐’•๐’†๐’”๐’•


Other helpful diagnostic tests


* CBC

* mono spot (if concerned about other diagnoses such as Mononucleosis caused by another virus


Treatment :


For both


Supportive therapy with antipyretics (Acetaminophen or Ibuprofen ), analgesics, throat lozenges, and saltwater gargles; encourage soft and cold foods


* If bacterial pharyngitis is the cause you need an immediate visit to your Primary Care Provider (Physician or NP)


No treating Bacterial Pharyngitis can lead to severe health complications


If you ever experience this condition and see no improvement after 3 days with Fever and tonsillar exudates. You need to visit a health care provider immediately.




References


Fenstermacher, K., & Hudson, B. T. (2016). Chapter 7. Eye, ear, nose, and throat conditions. In Practice guidelines for family nurse practitioners (4th ed., pp. 236-238). W B Saunders Company.

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