Pharyngitis+and+Bronchitis

Pharyngitis and Bronchitis ​ by Adam Karmally and Caitlin Kendall Pharyngitis by Adam Karmally Abstract:  Pharyngitis is an infection of the pharynx, and is classified as an upper respiratory infection. Viruses such as Coronavirus and Rhinovirus are the most common viruses that cause pharyngitis, whereas the most common bacteria that causes pharyngitis is //Streptococcus pyogene.// In my paper I focused mostly on the causing agents of pharyngitis to get a better understanding of how we can prevent and efficiently treat pharyngitis because hopefully in my future I see myself tackling these problems.

(Also see my page: More Scientific Information on Pharyngitis)
Introduction:  The research of pharyngitis was of interest to me because almost everyone in my family has gotten this infection. I wanted to learn what the causes were and why my family was infected with it. Was it bad luck or was the environment around us the reason for this infection? I also decided to research this topic because I someday hope to pursue my dreams of medical school. As a physician, it is one of the most common reasons why people visit family physicians. I’m very interested in the respiratory track and hope to learn more about it. For our research I decided to research pharyngitis (an upper respiratory infection), and my partner Catlin choose bronchitis (A lower respiratory infection). Even though we worked on our research seperately, at the end we compared the two. We thought it will be cool to see if there are major differences in the causes of upper & lower respiratory infections. Through my research I found that the bacteria and viruses that cause the two are different mainly because they are temperature sensitive, meaning some can’t reproduce at a given temperature and spread. As we learned in class if bacteria can’t reproduce it is considered death.



Brief discussion : What is pharyngitis: Pharyngitis is the inflammation of the pharynx and is classified as an upper respiratory infection. The pharynx is the part of the neck and throat situated immediately posterior (behind) to the mouth and nasal cavity. It functions as the passage way for food and air. People infected with pharyngitis have a sore throat that is very bothersome. This makes swallowing very difficult and painful. It is a common reason why many people visit family physicians. Very rarely is pharyngitis serious and the best cure for it is rest. It usually clears up within a week or two of the infection. Pain relievers are used to ease the discomfort. Rarely, though, tissues may swell considerably and obstruct breathing, which would result in a life threatening conditions.

Causes of pharyngitis: Pharyngitis is mostly caused by viruses and bacteria causing agents.

Bacterial Causes : 

//Streptococcus pyogene//- The most significant bacterial agent causing pharyngitis in both adults and children is //Streptococcus pyogenes. Streptococcus pyogenes// is a Gram-positive facultative anaerobic bacterium. It is not motile, and does not produce spores. It occurs as long chains of cocci, and occasionally in pairs. //S pyogenes// tends to colonize the upper respiratory tract and is highly potent as it overcomes the host defense system. The cell wall of //S pyogenes// is very complex and chemically diverse. The antigenic components of the cell are the virulence factors. The extracellular components responsible for the disease process include invasins and exotoxins. The outermost capsule is composed of hyaluronic acid, which has a chemical structure resembling host connective tissue, allowing the bacterium to escape recognition by the host as an offending agent. Thus, the bacterium escapes phagocytosis by neutrophils or macrophages, allowing it to colonize. Through further research I found that phagocytosis is the intake of molecules by engulfing them. It is a type of endocytosis ( Pechere, 2003). 

Other bacterial causes that have been known to cause pharyngitis but are not too common are:

-//Arcanobacterium haemolyticus//

-//Mycoplasma pneumoniae// and Chlamydia pneumonia are other bacterial agents that cause pharyngitis.

-//Neisseria gonorrhoeae//- Very rarely does it cause pharyngitis but there have been some cases in which it has done so. The reason I mention this is because it is one of the aerobic, gram negative bacteria we learned in chapter 11 (Tortora, Funke, and Case, 2009). <span style="font-family: 'Comic Sans MS',cursive;"> <span style="color: #0c6f0c; font-family: 'Comic Sans MS',cursive; font-size: 14.4pt; line-height: 115%;">

Viral Causes: <span style="font-family: 'Comic Sans MS',cursive; font-size: 12pt; line-height: 115%;"> Most common viruses that cause pharyngitis are rhinovirus and coronavirus.

Rhinovirus: They are classes of viruses most known for causing the common cold. They are one of the most common virsues that lead to pharyngitis. Rhinoviruses are positive strand RNA viruses with a naked nucleocapsid. They are sensitive to low pH and are spread by aerosols and infect the upper respiratory track. Rhinoviruses are quite stable, lasting for hours on fomites, but are sensitive to temperature. Since they are sensitive to temp. they do not spread to the lower respiratory tract because they replicate best at a few degrees below normal body temp (Strauss, 2007).

Coranovirus: are another common virus that cause the common cold as well as pharyngitis. They were first isolated from chickens in 1937. They are the largest positive strand RNA viruses. They infect humans and animlas in which they cause respiratory infections such as pharyngitis. Most people harbor anti-coronavirus antibodies but reinfection is common indicating that there are many circulating serotypes of the virus in the human population. Most coronavirus infections go undiagnosed and the disease is self-limiting. Diagnosis can be carried out using immuno-electron microscopy and serology. Over the counter remedies are used to alleviate some of the symptoms (Strauss, 2007).

<span style="font-family: 'Tahoma','sans-serif'; font-size: 9.5pt; line-height: 115%;">Scientific article from SSU data base:

Title: <span style="font-family: 'Tahoma','sans-serif'; font-size: 10.5pt; line-height: 115%;">Sensitivity and specificity of rapid antigen detection testing for diagnosing //<span style="font-family: 'Tahoma','sans-serif';">pharyngitis // in the emergency department

Article: <span style="font-family: 'Tahoma','sans-serif'; font-size: 9.5pt; line-height: 115%;">Acute //<span style="font-family: 'Tahoma','sans-serif';">pharyngitis // in adults is primarily a viral infection; only about 10% of cases are of bacterial etiology. Most cases of bacterial //<span style="font-family: 'Tahoma','sans-serif';">pharyngitis // are caused by group A beta-hemolytic streptococci (GABHS). One laboratory method for the diagnosis of GABHS is rapid antigen diagnostic testing (RADT), which can be processed during an emergency <span style="font-family: 'Tahoma','sans-serif'; font-size: 9.5pt; line-height: 115%;">department visit and which has become a popular alternative to throat swab cultures. In the article they conducted a study to define the sensitivity and specificity of RADT. By using throat culture results as the gold standard in 100 emergency department patients who presented with symptoms consistent with streptococcal //<span style="font-family: 'Tahoma','sans-serif';">pharyngitis, //They<span style="font-family: 'Tahoma','sans-serif'; font-size: 9.5pt; line-height: 115%;"> found that RADT had a sensitivity of 68.2% (15 of 22), a specificity of 89.7% (70 of 78), a positive predictive value of 65.2% (15 of 23), and a negative predictive value of 90.9% (70 of 77). They concluded that RADT is useful in the emergency department when the clinical suspicion is GABHS, but results should be confirmed with a throat culture in patients whose RADT results are negative<span style="font-family: 'Tahoma','sans-serif'; font-size: 9.5pt; line-height: 115%;"> (Celikmen, Cetin, Ay, Akta, and Sarikaya, 2010).

<span style="color: #096209; font-family: 'Comic Sans MS',cursive; font-size: 14.4pt;">Symptoms: <span style="font-family: 'Comic Sans MS',cursive; font-size: 12pt;">The symptoms for children may be more painful and abundant since there immune system is not as developed. Children with pharyngitis have a sore throat and some degree of pain when they swallow. Their ears may be painful because the throat and ears share the same nerves. The back of the throat and tonsils are typically red, and the tonsils may be enlarged or coated with a white discharge. For adults: there symptoms are pretty similar · Sore or red throat · Difficulty swallowing · Tender swollen lymph nodes in the neck · Swollen tonsils <span style="color: #008000; font-family: 'Comic Sans MS',cursive; font-size: 14.4pt;">

Treatments: · <span style="font-family: 'Comic Sans MS',cursive; font-size: 12pt;">Rest and time is probably the best medicine for pharyngitis. However to alleviate some of the pain and or symptoms you can try many things such as taking nonprescription pain relievers like aspirin. · Drink lots of fluid such as water and warm broths. Warm broths are probably the most soothing for pharyngitis. · Antibiotics are prescribed for pharyngitis caused by bacteria. These drugs are effective in killing bacteria, and certain other organisms, but not viruses. · Pharyngitis caused by viruses clears up on its own. Antibiotics are not effective against viral infections, so treatment is aimed at easing symptoms. One should not drink or smoke because that will irritate your throat and cause your symptoms to worsen. · Toxic fumes, air pollution, or industrial chemicals should be avoided as well.

More Scientific Information on Pharyngitis
<span style="color: #008000; font-family: 'Comic Sans MS',cursive; font-size: 14.4pt;">References: (Literature Cited?) <span style="font-family: 'Comic Sans MS',cursive; font-size: 12pt;">Pechere, J. C.. __Streptococcal Pharyngitis: Optimal Management (Issues in Infectious Diseases, V. 3)__. S. Karger, December 2003.

Strauss, James H.. __Viruses and Human Disease, Second Edition__. Academic Press; 2 edition, October 1, 2007.

"Pharyngitis". University of Maryland Merdical Center. May 10, 2010 <http://www.umm.edu/altmed/articles/pharyngitis-000129.htm> <span style="font-family: 'Comic Sans MS',cursive;">.

Tortora, Gerard, Berdell Funke, and Christine Case. Microbiology:An Introduction. 10th eddition. Benjamin Cummings, 2009.960.print

<span style="background-color: #000000; color: #7c137c; display: block; font-family: 'Comic Sans MS',cursive; font-size: 300%; text-align: center;">Bronchitis

<span style="color: #580e58; display: block; font-family: 'Comic Sans MS',cursive; font-size: 14.4pt; text-align: center;">Abstract: <span style="display: block; font-family: 'Comic Sans MS',cursive; font-size: 12pt; text-align: left;"> Bronchitis is a condition that affects the 2 branches of the windpipe that lead to the lungs also known as the Bronchial tubes. Bronchitis can either be acute, short term following a cold in an otherwise healthy person, or chronic generally occuring in a person with chronic obstructive pulmonary disease (COPD). When you have chronic bronchitis, there is long-lasting inflammation of the bronchial tubes that causes shortness of breath, and coughing with discolored mucus that lasts for months or even years. If you have chronic bronchitis, your bronchial tubes are more likely to become infected by bacteria because they are already irritated. This can cause symptoms to feel worse than usual. Such an infection is called an acute bacterial exacerbation of chronic bronchitis, or ABECB. ABECB can last up to 10 days. During that time, your symptoms will be worse than usual. After your ABECB infection has cleared, you will still have chronic bronchitis <span style="color: #580e58; display: block; font-family: 'Comic Sans MS',cursive; font-size: 14.4pt; text-align: center;">

Information: <span style="color: #000000; display: block; font-family: 'Comic Sans MS',cursive; font-size: 12pt; text-align: left;"> Bronchitis is a common illness that many people have to deal with at least 5 times in their life times. Its so common and many people believe it to be something that can be treated with antibiotics but that is simply not the case. Its literally just a common cold that can turn out to be much more severe and lead to much more harmful illnesses if its not taken care of. I chose to research Bronchitis because I've had it twice and my little brothers seem to get hit with it all of the time. I have always been curious as to how to get rid of the infection or what else could be connected to it. <span style="color: #580e58; display: block; font-family: 'Comic Sans MS',cursive; font-size: 14.4pt; text-align: center;"> Discussions

What causes Bronchitis: <span style="color: #000000; display: block; font-family: 'Comic Sans MS',cursive; font-size: 12pt; text-align: left;">Bronchitis is usually caused by infection with a virus. However, bacteria, smoking or the inhalation of chemical pollutants or dust may also cause bronchitis. The most common causes of bronchitis are //Haemophilus Influenza// type A and B and //Mycoplasma Pneumonia//.



<span style="color: #580e58; display: block; font-family: 'Comic Sans MS',cursive; font-size: 14.4pt; text-align: left;">

Haemophilus Influenzae <span style="color: #000000; display: block; font-family: 'Comic Sans MS',cursive; font-size: 12pt; text-align: left;"> //Haemophilus influenzae// is a small (1 µm X 0.3 µm), pleomorphic, gram-negative coccobacillus. It is a nonmotile, non–spore-forming, fastidious, facultative anaerobe. Some strains of //H influenzae// possess a polysaccharide capsule. These strains are serotyped into 6 different types (a-f) based on their biochemically different capsules. Some strains have no capsule and are termed nonencapsulated //H influenzae////H influenzae//. The different strains can be identified with slide agglutination for serotyping or polymerase chain reaction aka PCR for capsular typing. Transmission of //H influenzae// is by direct contact or by inhalation of respiratory tract droplets. A larger bacterial load or the presence of a co contaminant viral infection can potentiate the infection. The antiphagocytic nature of the Hib capsule and the absence of the anticapsular antibody lead to increasing bacterial proliferation. When the bacterial concentration exceeds a critical level, it can disseminate to various sites, including the meninges, subcutaneous tissue, joints, pleura, pericardia, and the lungs.

<span style="color: #7c137c; display: block; font-family: 'Comic Sans MS',cursive; font-size: 14.4pt; text-align: left;"> Mycoplasma Pneumoniae <span style="color: #000000; display: block; font-family: 'Comic Sans MS',cursive; font-size: 12pt; text-align: left;">//Mycoplasma pneumoniae// is a member of the class Mollicutes, meaning soft skin. Along with the other members of its class Mycoplasma are characterized by their unusually small genome as well as their complete lack of a bacterial cell wall. which leads to osmotic instability. To create some structural support, //M. pneumoniae// utilizes sterols, much like eukaryotic cells, in its triple-layered membrane. the bacterium may be able to survive without a cell wall because it lives in an osmotically stable environment, the animal (human) host, as well as its protein network which resembles an ancestral cytoskeleton. The combination of these unique characteristics creates a different scenario for treatment of a mycoplasmal infection than other bacteria. The lack of a cell wall prevents the utilization of a B-lactam antibiotic, such as penicillin and cycloserine, because they act specifically to disrupt the cell wall. Mycoplasma pneumoniae contains an adhesive protein that attaches itself to specific receptors that are located at the bases of cilia on the epithelial cells lining of the human respiratory tracts. The bacterium will extract nutrients from the mucosa of the host organism to allow them to grow and reproduce quickly. Mycoplasma pneumoniae undergoes asexual reproduction by binary fission. A single cell will grow until a maximum size and then start to undergo cell division which separate the original cell into two. The two cells then grow and reproduce again to produce a bacterium colony. The attachment of the bacteria causes the cilia of human respiratory tract to stop beating. Besides that, the bacteria colonization also kills the epithelial cells of the respiratory tract. This allows other bacteria to colonize the respiratory tract and causes mucus to accumulate and irritates the respiratory tract.

<span style="color: #580e58; display: block; font-family: 'Comic Sans MS',cursive; font-size: 14.4pt; text-align: left;">Symptoms <span style="color: #000000; display: block; font-family: 'Comic Sans MS',cursive; font-size: 12pt; text-align: left;"> Common symptoms include chest discomfort, a cough that produces mucus, fatigue, wheezing, fever and shortness of breath worsened by exertion of mild activity. There are two types of Bronchitis; Acute bronchitis and Chronic Bronchitis. If you have acute bronchitis, you may have a nagging cough that lingers for several weeks after the bronchitis resolves. However, bronchitis symptoms can be deceptive. You don't always produce sputum when you have bronchitis, and children often swallow coughed-up material, so parents may not know there's a secondary infection. You can develop chronic bronchitis without first developing acute bronchitis. And many smokers have to clear their throats every morning when they get up, which, if it continues for more than three months, may be chronic bronchitis If you have chronic bronchitis, long-term inflammation leads to scarring of the bronchial tubes, producing excessive mucus. Over time, the lining of the bronchial tubes thickens, and your airways eventually may become scarred. Signs and symptoms of chronic bronchitis may also include a cough that's worse in the mornings and in damp weather and frequent respiratory infections (such as colds or the flu) with a worsening productive cough. <span style="color: #580e58; display: block; font-family: 'Comic Sans MS',cursive; font-size: 14.4pt; text-align: left;"> Treatment and Prevention: <span style="color: #000000; display: block; font-family: 'Comic Sans MS',cursive; font-size: 12pt; text-align: left;">The majority of cases of Bronchitis stem from viral infections. This means that most cases of bronchitis are short-term and require nothing more than treatment of symptoms to relieve discomfort. Acetaminopen, asprin or ibuprofin will help with fever and muscle aches. Drinking fluids is very importan becase fever causes the body to lose fluid faster. Basically your treating the common cold. To help prevent Bronchitis, stop smoking. Avoid exposure to irritants. Proper protection in the workplace is vital to prevent exposure.

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<span style="color: #7c137c; display: block; font-family: 'Comic Sans MS',cursive; font-size: 14.4pt; text-align: left;">References: <span style="display: block; font-family: 'Comic Sans MS',cursive; font-size: 12pt; text-align: left;">"Bronchitis." //WebMD//. EMedicineHealth, 2010. Web. 10 May 2010. <http://http://www.emedicinehealth.com/bronchitis/article_em.htm>.

Braman SS. Diagnosis and management of cough: ACCP Evidence-Based Clinical Practice Guidelines.// Chest//. 2006;129:1S-23S.

Gwaltney JM. Acute bronchitis. In: Mandell GL, Bennett JE, Dolin R, eds.// Principles and Practice of Infectious Diseases//. 6th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2005:chap 58.