The pain that is localized to the pharynx and the surrounding structures is known as sore throat. Sore throat can be the symptom of a disease that is not directly affecting the pharynx. Ample time should be allocated to thoroughly exam and identify the actual cause of a sharp throat pain in patients with no additional sign or symptom to direct the diagnosis and treatment.
A life-threatening upper airway infection is epiglottitis which is the infection of the epiglottis that is the flap of cartilage located in the throat behind the tongue and in front of the larynx. The incidence of this condition is significantly reduced thanks to vaccination against Haemophilus influenzae type b. These patients have high fever, sore throat and drooling which is the flow of saliva outside the mouth mainly due to inability to swallow for the extreme pain.
Sometimes abscesses develop behind the pharynx which is known as retropharyngeal abscess. It is primarily seen in earlier ages and these patients have neck pain and fever. It makes swallowing painful and respiration difficult. It is hard to see this lesion as it is located posteriorly. A close clinical entity is lateral pharyngeal abscess, which is seen with high fever, throat pain and swelling below the mandible.
Sometimes a preexisting pharyngeal infection is complicated by a peritonsillar abscess even though this can be a separate disease. This abscess could be seen with eye and causes deviation of the uvula to the normal side of the pharynx. The bulging created by the abscess is evident behind the soft palate.
Less Common Causes
Diphtheria can become a life-threatening condition but it is rarely seen these days thanks to vaccination. Thick pharyngeal membrane and enlarged lymph node in the neck characterize this disease. Another less common disease is called Lemierre's syndrome that is caused by Fusobacterium necrophorum. These patients almost always have pharyngitis.
Viral and Bacterial Infections
There are common infectious conditions which in fact constitutes the majority of cases but they are self-limiting (viral) or easily identified and treated (streptococci or other bacteria). These conditions are presented by pharyngitis. Infectious pharyngitis can also be caused by unusual infections which make a long list of bacteria and viruses.
During winter months, drying of the pharynx can irritate the mucosa and cause pain which is known as irritative pharyngitis. Sometimes, foreign objects such as fish bone become embedded in the pharynx and cause pain. Acute pharyngitis can also be seen with herpes simplex virus infection and some inflammatory diseases. It is not uncommon to experience sharp throat pain with exposure to chemicals such as alkali or even some medication. Occasionally, pharyngeal pain could be referred from other sites such as an ear infection or dental abscess. It should always be remembered to see a physician when there is a concern of a serious medical condition.
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