Pharyngitis is an infection or irritation of the pharynx and tonsils. It rarely occurs in infants younger than 1 year and is uncommon in infants younger than 2 years. It peaks between the ages of 4 to 7 years but recurs throughout life. Seasonal variation occurs, with a higher incidence in winter. 1

Causal agents of pharyngitis include viruses, bacteria, fungi, and parasites ( Tab-le... .2.3.5.-.1). Most often, viruses are the culprits. Rhinovirus and adenovirus are the most common, but Epstein-Barr virus, herpes simplex virus, influenzavirus, parainfluenzavirus, and coronavirus are responsible for about 5 percent of the infections. 2 Fungal and, very rarely, parasitic infection occurs in an immunocompromised host, but such infections are rarely found in immunocompetent patients. The most common bacteria causing pharyngitis include Streptococcus pyogenes [group A b-hemolytic streptococcus (GABHS)], Mycoplasma, Chlamydia, Neisseria, and Corynebacterium. GABHS is responsible for 15 percent of all pharyngitis and is associated with significant nonsuppurative sequelae in the form of acute rheumatic fever (ARF) or acute glomerulonephritis (AGN).2 Because of the sequelae associated with GABHS, there is a greater emphasis placed on early diagnosis and treatment of this causal agent. This organism produces three extracellular pyrogenic exotoxins (A, B, and C) that facilitate tissue penetration. Almost every body tissue is subject to infection, but the skin and throat are favorite targets because of host-dependent surface receptor sites. 2


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