Sykes Edward A, Wu Vincent, Beyea Michael M, Simpson Matthew T W, Beyea Jason A
First-year resident, Department of Otolaryngology-Head and Neck Surgery at the University of Toronto in Ontario.
Second-year resident, Department of Otolaryngology-Head and Neck Surgery at the University of Toronto in Ontario.
Can Fam Physician. 2020 Apr;66(4):251-257.
To provide family physicians with an updated approach to diagnosis and treatment of pharyngitis, detailing key symptoms, methods of investigation, and a summary of common causes.
The approach described is based on the authors' clinical practice and peer-reviewed literature from 1989 to 2018.
Sore throat caused by pharyngitis is commonly seen in family medicine clinics and is caused by inflammation of the pharynx and surrounding tissues. Pharyngitis can be caused by viral, bacterial, or fungal infections. Viral causes are often self-limiting, while bacterial and fungal infections typically require antimicrobial therapy. Rapid antigen detection tests and throat cultures can be used with clinical findings to identify the inciting organism. Pharyngitis caused by is among the most concerning owing to its associated severe complications such as acute rheumatic fever and glomerulonephritis. Hence, careful diagnosis of pharyngitis is necessary to provide targeted treatment.
A thorough history is key to diagnosing pharyngitis. Rapid antigen detection tests should be reserved for concerns about antibiotic initiation. Physicians should exercise restraint in antibiotic initiation for pharyngitis, as restraint does not delay recovery or increase the risk of infections.
为家庭医生提供咽炎诊断和治疗的最新方法,详细阐述关键症状、检查方法及常见病因总结。
所描述的方法基于作者的临床实践以及1989年至2018年的同行评审文献。
咽炎引起的咽痛在家庭医学诊所很常见,是由咽部及周围组织的炎症引起的。咽炎可由病毒、细菌或真菌感染引起。病毒感染通常具有自限性,而细菌和真菌感染通常需要抗菌治疗。快速抗原检测试验和咽拭子培养可结合临床症状用于识别致病微生物。[此处原文缺失具体病因,无法完整翻译]引起的咽炎因其相关的严重并发症如急性风湿热和肾小球肾炎而备受关注。因此,仔细诊断咽炎对于提供针对性治疗很有必要。
详尽的病史是诊断咽炎的关键。快速抗原检测试验应仅用于考虑开始使用抗生素的情况。医生在咽炎治疗中应谨慎使用抗生素,因为谨慎使用不会延迟康复或增加[此处原文缺失具体感染类型,无法完整翻译]感染的风险。