ជំងឺរលាកបំពង់ក

ដោយវិគីភីឌា
Jump to navigation Jump to search
ជំងឺរលាកបំពង់ក
(Pharyngitis)
Classification and external resources
Inflamed oropharynx: swollen and red.
ICD-10 J02., J31.2
ICD-9 462, 472.1
DiseasesDB 24580
MedlinePlus 000655
eMedicine emerg/419
MeSH D010612

ជំងឺរលាកបំពង់ក (ពាក្យបច្ចេកទេស Pharyngitis /færɨnˈtɨs/ មកពីពាក្យជាភាសាក្រិច pharynx pharanx មានន័យថា បំពង់ក និង បច្ច័យបទ (ពាក្យនៅខាងក្រោយ suffix) -itis មាន័យថា រលាក-ឆេះ។ ដូចនេះវាមានន័យសមញ្ញថា ការរលាកបំពង់ក។[១] ករណីភាគច្រើន រោគនេះបង្កឲ្យមានភាពឈឺចាប់ ហើយមូលហេតុបង្កជាទូទៅនោះគីស្អកក[២]

Like many types of inflammation, pharyngitis can be acute – characterized by a rapid onset and typically a relatively short course – or chronic. Pharyngitis can result in very large tonsils which cause trouble swallowing and breathing. Pharyngitis can be accompanied by a cough or fever, for example, if caused by a systemic infection.

Most acute cases are caused by viral infections (40–80%), with the remainder caused by bacterial infections, fungal infections, or irritants such as pollutants or chemical substances.[២][៣] Treatment of viral causes are mainly symptomatic while bacterial or fungal causes may be amenable to antibiotics and anti-fungal respectively.

Classification[កែប្រែ]

Pharyngitis is a type of inflammation, most commonly caused by an upper respiratory tract infection. It may be classified as acute or chronic. An acute pharyngitis may be catarrhal, purulent or ulcerative, depending on the virulence of the causative agent and the immune capacity of the affected individual. Chronic pharyngitis is the most common otolaringologic disease and may be catarrhal, hypertrophic or atrophic.

If the inflammation includes tonsillitis, it is called pharyngotonsillitis.[៤] Another sub classification is nasopharyngitis (the common cold).[៥]

មូលហេតុបង្ក[កែប្រែ]

The majority of cases are due to an infectious organism acquired from close contact with an infected individual.

ប្រភេទឆ្លង[កែប្រែ]

តាមមេរោគវីរុស

These comprise about 40–80% of all infectious cases and can be a feature of many different types of viral infections.[២][៣]

តាមមេរោគបាក់តេរី

A number of different bacteria can infect the human throat. The most common is Group A streptococcus, however others include Streptococcus pneumoniae, Haemophilus influenzae, Bordetella pertussis, Bacillus anthracis, Corynebacterium diphtheriae, Neisseria gonorrhoeae, Chlamydophila pneumoniae, and Mycoplasma pneumoniae.[៦]

Streptococcal pharyngitis
A case of strep throat

Streptococcal pharyngitis or strep throat is caused by group A beta-hemolytic streptococcus (GAS).[៧] It is the most common bacterial cause of cases of pharyngitis (15–30%).[៦] Common symptoms include fever, sore throat, and large lymph nodes. It is a contagious infection, spread by close contact with an infected individual. A definitive diagnosis is made based on the results of a throat culture. Antibiotics are useful to both prevent complications and speed recovery.[៨]

Fusobacterium necrophorum

Fusobacterium necrophorum are normal inhabitants of the oropharyngeal flora. Occasionally however it can create a peritonsillar abscess. In 1 out of 400 untreated cases Lemierre's syndrome occurs.[៩]

Diphtheria

Diphtheria is a potentially life threatening upper respiratory infection caused by Corynebacterium diphtheriae which has been largely eradicated in developed nations since the introduction of childhood vaccination programs, but is still reported in the Third World and increasingly in some areas in Eastern Europe. Antibiotics are effective in the early stages, but recovery is generally slow.[ត្រូវការអំណះអំណាង]

Others

A few other causes are rare, but possibly fatal, and include parapharyngeal space infections: peritonsillar abscess ("quinsy"), submandibular space infection (Ludwig's angina), and epiglottitis.[១០][១១][១២]

Fungal

Some cases of pharyngitis are caused by fungal infection such as Candida albicans causing oral thrush.[ត្រូវការអំណះអំណាង]

ប្រភេទមិនឆ្លង[កែប្រែ]

Pharyngitis may also be caused by mechanical, chemical or thermal irritation, for example cold air or acid reflux. Some medications may produce pharyngitis such as pramipexole and antipsychotics.[១៣][១៤]

Diagnostic approach[កែប្រែ]

Modified Centor score
Points Probability of Strep Management
1 or less <10% No antibiotic or culture needed
2 11–17% Antibiotic based on culture or RADT
3 28–35%
4 or 5 52% Empiric antibiotics

It is hard to differentiate a viral and a bacterial cause of a sore throat based on symptoms alone.[១៥] Thus often a throat swab is done to rule out a bacterial cause.[១៦]

The modified Centor criteria may be used to determine the management of people with pharyngitis. Based on 5 clinical criteria, it indicates the probability of a streptococcal infection.[៨]

One point is given for each of the criteria:[៨]

  • Absence of a cough
  • Swollen and tender cervical lymph nodes
  • Temperature >៣៨,០ °C (១០០,៤ °F)
  • Tonsillar exudate or swelling
  • Age less than 15 (a point is subtracted if age >44)

The McIsaac criteria adds to the Centor:[១៧]

  • Age less than 15: add one point
  • Age greater than 45: subtract one point

The Infectious Disease Society of America however recommends against empirical treatment and considers antibiotics only appropriate following positive testing.[១៥] Testing is not needed in children under three as both group A strep and rheumatic fever are rare, except if they have a sibling with the disease.[១៥]

Management[កែប្រែ]

The majority of time treatment is symptomatic. Specific treatments are effective for bacterial, fungal, and herpes simplex infections.

Medications[កែប្រែ]

Alternative[កែប្រែ]

Alternative medicines are promoted and used for the treatment of sore throats.[២៣] However, they are poorly supported by evidence.[២៣]

Epidemiology[កែប្រែ]

Acute pharyngitis is the most common cause of a sore throat and, together with cough, it is diagnosed in more than 1.9 million people a year in the United States.[២]

ឯកសារយោង[កែប្រែ]

  1. "pharyngitis" at Dorland's Medical Dictionary
  2. ២,០ ២,១ ២,២ ២,៣ Marx, John (2010). Rosen's emergency medicine: concepts and clinical practice (7th ed.). Philadelphia, Pennsylvania: Mosby/Elsevier. Chapter 30. ISBN 978-0-323-05472-0.
  3. ៣,០ ៣,១ Acerra JR. "Pharyngitis". eMedicine. Retrieved 28 ខែមេសា 2010.
  4. doi:10.1016/j.pcl.2005.10.001
    This citation will be automatically completed in the next few minutes. You can jump the queue or expand by hand
  5. "www.nlm.nih.gov".
  6. ៦,០ ៦,១ Bisno AL (2001). "Acute pharyngitis". N Engl J Med. 344 (3): 205–11. doi:10.1056/NEJM200101183440308. PMID 11172144. Unknown parameter |month= ignored (help)
  7. Baltimore RS (2010). "Re-evaluation of antibiotic treatment of streptococcal pharyngitis". Curr. Opin. Pediatr. 22 (1): 77–82. doi:10.1097/MOP.0b013e32833502e7. PMID 19996970. Unknown parameter |month= ignored (help)
  8. ៨,០ ៨,១ ៨,២ Choby BA (2009). "Diagnosis and treatment of streptococcal pharyngitis". Am Fam Physician. 79 (5): 383–90. PMID 19275067. Unknown parameter |month= ignored (help) Cite error: Invalid <ref> tag; name "Review09" defined multiple times with different content
  9. Centor RM (1 ខែធ្នូ 2009). "Expand the pharyngitis paradigm for adolescents and young adults". Ann Intern Med. 151 (11): 812–5. doi:10.1059/0003-4819-151-11-200912010-00011. PMID 19949147.
  10. "UpToDate Inc". (registration required)
  11. Reynolds SC, Chow AW (2009 Sep-Oct). "Severe soft tissue infections of the head and neck: a primer for critical care physicians". Lung. 187 (5): 271–9. doi:10.1007/s00408-009-9153-7. PMID 19653038. Check date values in: |date= (help)
  12. Bansal A, Miskoff J, Lis RJ (2003 Jan). "Otolaryngologic critical care". Crit Care Clin. 19 (1): 55–72. doi:10.1016/S0749-0704(02)00062-3. PMID 12688577. Check date values in: |date= (help)CS1 maint: Multiple names: authors list (link)
  13. "Mirapex product insert" (PDF). Boehringer Ingelheim. 2009. Retrieved 30 ខែមិថុនា 2010.
  14. "Mosby's Medical Dictionary, 8th edition". Elsevier. 2009. Retrieved 30 ខែមិថុនា 2010.
  15. ១៥,០ ១៥,១ ១៥,២ Shulman, ST (2012 Sep 9). "Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America". Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. PMID 22965026. Unknown parameter |coauthors= ignored (|author= suggested) (help); Check date values in: |date= (help)
  16. Del Mar C (1992). "Managing sore throat: a literature review. I. Making the diagnosis". Med J Aust. 156 (8): 572–5. PMID 1565052.
  17. Fine AM, Nizet V, Mandl KD (2012). "Large-Scale Validation of the Centor and McIsaac Scores to Predict Group A Streptococcal Pharyngitis". Arch Intern Med. doi:10.1001/archinternmed.2012.950. PMID 22566485.CS1 maint: Multiple names: authors list (link)
  18. Thomas M, Del Mar C, Glasziou P (2000). "How effective are treatments other than antibiotics for acute sore throat?". Br J Gen Pract. 50 (459): 817–20. PMC 1313826. PMID 11127175. Unknown parameter |month= ignored (help)CS1 maint: Multiple names: authors list (link)
  19. Hayward G, Thompson M, Heneghan C, Perera R, Del Mar C, Glasziou P (2009). "Corticosteroids for pain relief in sore throat: systematic review and meta-analysis". BMJ. 339: b2976. doi:10.1136/bmj.b2976. PMC 2722696. PMID 19661138.CS1 maint: Multiple names: authors list (link)
  20. "Do steroids reduce symptoms in acute pharyngitis?". BestBets.org. Retrieved 14 ខែមករា 2009.
  21. "LIDOCAINE VISCOUS (Xylocaine Viscous) side effects, medical uses, and drug interactions".
  22. Del Mar CB, Glasziou PP, Spinks AB (2004). Del Mar, Chris (ed.). "Antibiotics for sore throat". Cochrane Database Syst Rev (2): CD000023. doi:10.1002/14651858.CD000023.pub2. PMID 15106140.CS1 maint: Multiple names: authors list (link) - Meta-analysis of published research
  23. ២៣,០ ២៣,១ "Sore throat: Self-care". Mayo Clinic. Retrieved 17 ខែកញ្ញា 2007.