By: Leonard Einstein , APRN, NP-C, FNP-BC
Board Certified Nurse Practitioner
𝑩𝒂𝒄𝒕𝒆𝒓𝒊𝒂𝒍 𝒐𝒓 𝑽𝒊𝒓𝒂𝒍 ?
𝑨𝒏𝒕𝒊𝒃𝒊𝒐𝒕𝒊𝒄𝒔 ? 𝑶𝒓 𝒔𝒖𝒑𝒑𝒐𝒓𝒕𝒊𝒗𝒆 𝒕𝒓𝒆𝒂𝒕𝒎𝒆𝒏𝒕 𝒐𝒏𝒍𝒚 ?
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 𝑩𝒂𝒄𝒕𝒆𝒓𝒊𝒂𝒍 𝑷𝒉𝒂𝒓𝒚𝒏𝒈𝒊𝒕𝒊𝒔
* acute-onset 𝑺𝒐𝒓𝒆 𝑻𝒉𝒓𝒐𝒂𝒕 with 𝑻𝒐𝒏𝒔𝒊𝒍𝒂𝒓 𝒆𝒙𝒖𝒅𝒂𝒕𝒆𝒔 (*MAJORILY Bacterial )
* 𝑭𝒆𝒗𝒆𝒓 (Bacterial) , 𝑯𝒆𝒂𝒅𝒂𝒄𝒉𝒆𝒔
* 𝑬𝒏𝒍𝒂𝒓𝒈𝒆𝒅 /𝒕𝒆𝒏𝒅𝒆𝒓 𝒄𝒆𝒓𝒗𝒊𝒄𝒂𝒍 𝒏𝒐𝒅𝒆𝒔
* 𝑨𝒃𝒔𝒆𝒏𝒔𝒆 𝒐𝒇 𝑪𝒐𝒖𝒈𝒉 𝒂𝒏𝒅 𝒂𝒃𝒔𝒆𝒏𝒄𝒆 𝒐𝒇 𝑺𝒕𝒖𝒇𝒇𝒚 𝒏𝒐𝒔𝒆 *(Bacterial indicator)
* 𝑴𝒂𝒚 𝒉𝒂𝒗𝒆 𝒔𝒂𝒏𝒅𝒑𝒂𝒑𝒆𝒓 𝒓𝒂𝒔𝒉 𝒐𝒏 𝒕𝒐𝒓𝒔𝒐 𝒐𝒓 𝒑𝒆𝒕𝒆𝒄𝒉𝒊𝒂𝒆 𝒐𝒇 𝒔𝒐𝒇𝒕 𝒑𝒂𝒍𝒂𝒕𝒆 (𝑵𝑶 𝑨𝑳𝑾𝑨𝒀𝑺)
A common presentation of viral pharyngitis
* Sore throat
* 𝑪𝒐𝒓𝒚𝒛𝒂 ( Only present in Viral)
* 𝑪𝒐𝒏𝒋𝒖𝒏𝒄𝒕𝒊𝒗𝒊𝒕𝒊𝒔 (𝑴𝒂𝒋𝒐𝒓𝒊𝒍𝒚 𝑽𝒊𝒓𝒂𝒍 )
* 𝑪𝒐𝒖𝒈𝒉 𝒂𝒏𝒅 𝒉𝒐𝒂𝒓𝒔𝒆𝒏𝒆𝒔𝒔 ( 𝑴𝒂𝒋𝒐𝒓𝒊𝒍𝒚 𝑽𝒊𝒓𝒂𝒍)
* May also have malaise (𝐭𝐢𝐫𝐞𝐝𝐧𝐞𝐬𝐬) , myalgia (𝗺𝐮𝐬𝐜𝐥𝐞 𝐩𝐚𝐢𝐧) , anorexia (𝐥𝐚𝐜𝐤 𝗼𝐟 𝐚𝐩𝐩𝐞𝐭𝐢𝐭𝐞) , difficulty swallowing (𝐝𝐲𝐬𝐩𝐡𝐚𝐠𝐢𝐚)
How to differentiate Viral from Bacterial?
In the office
* 𝑹𝒂𝒑𝒊𝒅 𝑺𝒕𝒓𝒆𝒑𝒕 𝒕𝒆𝒔𝒕
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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