Pharyngotonsillitis (PT) is characterized by the presence of increased redness and finding of an exudate, ulceration, or a membrane covering the tonsils. Because the pharynx is served by lymphoid tissues of the Waldeyer ring, an infection can spread to include various parts of the ring such as the nasopharynx, uvula, soft palate, tonsils, adenoids, and the cervical lymph glands. Based on the extent of the infection, the infection can be described as pharyngitis, tonsillitis, tonsillopharyngitis, or nasopharyngitis. The duration of any of these illnesses can be acute, subacute, chronic, or recurrent.

ETIOLOGY

The diagnosis of PT generally requires the consideration of group A β-hemolytic streptococci (GABHS) infection. However, numerous other bacteria, viruses, and other infections and noninfectious causes should be considered. Recognition of the cause and choice of appropriate therapy are of utmost importance in assuring rapid recovery and preventing complications.

Table 4.1 lists the different causative agents and their characteristic clinical features. The occurrence of a certain etiological agent depends on numerous variables that include environmental conditions (season, geographical location, exposure) and individual variables (age, host resistance, and immunity). The most prevalent agents accounting for PT are GABHS, adenovirus, influenza virus, parainfluenza virus, Epstein-Barr virus (EBV), and enterovirus. However, the exact etiology is generally not determined and the role of some potential pathogens is not certain.