Table 2.
Specific Clinical Characteristics Based on the Aetiological Germ of Acute Pharyngitis.
| Germs | Clinical characteristics |
|---|---|
| Virus | |
| Rhinovirus | Common cold. Predominates in autumn and winter |
| Coronavirus | Common cold. Predominates in winter |
| Influenza A and B | Common cold |
| Parainfluenza | Cold, laryngeal croup |
| Adenovirus | Pharyngoconjunctival fever. Predominates in summer |
| Coxsackie A Virus | Usually affects children. Epidemic outbreaks in summer. High fever. Severe odynophagia. Hyperaemia in tonsil pillars. Small, surface blisters with red halo. Hand, foot and mouth disease |
| Herpes simplex virus 1 and 2 | Gingivostomatitis, blisters and ulcers which affect the pharynx and the oral cavity. Can include pharyngeal exudate |
| Epstein–Barr virus (EBV) | Infectious mononucleosis. More common in adolescents. Fever. General malaise. Asthenia. Myalgia. Severe pharyngotonsillar inflammation, which can be obstructive and require intensive anti-inflammatory treatment. Tonsillar exudates in 50% of cases. Inflammation of cervical lymph nodes. Splenomegaly. Liver impairment. Taking antibiotics can result in a maculopapular rash on the trunk and extremities |
| Citomegalovirus | Mononucleosic syndrome. The pharyngotonsillitis is less severe compared to EBV and transaminase levels are more elevated |
| HIV | Primary infection: fever, myalgia, arthralgia, skin rash. Lymphadenopathies and ulceration on mucous membranes without exudate |
| Bacterias | |
| Group A streptococcus | Pharyngotonsillitis. Scarlet fever (from strains producing erythrogenic toxins). Maculopapulous rash more accentuated in the skin folds. Raspberry tongue. Flaking during convalescence. Possibility of rheumatic fever |
| Group C and G streptococcus | Pharyngotonsillitis |
| Arcanobacterium haemolyticum | Pharyngotonsillitis. Scarlet rash |
| Neisseria gonorrhoeae | Pharyngotonsillitis |
| Corynebacterium diphteriae | Pharyngeal exudate. Stridor. Cardiac impairment |
| Anaerobic bacteria | Plaut-Vincent angina. Gingivostomatitis |
| Fusobacterium necrophorum | Septic thrombophlebitis of the internal jugular: intense pain, dysphagia, swelling and stiff neck |
| Francisella tularensis | Pharyngotonsillitis. With a history of consumption of undercooked wild meat |
| Yersinia enterocolitica | Pharyngotonsillitis. Enterocolitis. Can involve exudate |
| Mycoplasma pneumoniae | Bronchitis. Pneumonia |
| Fungus | |
| Candida spp. | Immunosupressed patients, with multiple antibiotic treatments, inhaled cortico-steroids or chemoradiotherapy. Whitish exudate in pharynx and oral cavity. Surface involvement, with no fever or adenitis. |