The sore throat. Pharyngitis and epiglottitis

Sore throat can be caused by different microorganisms and diseases. Most cases of acute pharyngitis are caused by group A streptococcus or viruses; however, uncommon organisms may be suggested by other clinical information or the persistence of symptoms. A thorough history and physical examination are essential for the appropriate selection of diagnostic tests for sore throat. Routine testing for the uncomplicated case should consist of a pharyngeal culture in most patients, with rapid streptococcal antigen testing only for the more severe cases. Those with positive streptococcal tests should be treated to prevent rheumatic fever and mitigate symptoms in severe cases. Sore throat caused by viruses usually resolves spontaneously. Cases that persist should be thoroughly re-evaluated, with alternative causes being considered. Acute epiglottitis is a medical emergency and requires treatment with appropriate antibiotics for Hemophilus influenzae type b and intubation.