| disease | Viral Pharyngitis |
Viral pharyngitis is an acute infection of the pharynx caused by viruses. It often manifests as herpes in the pharynx, oral mucosa, and surrounding skin, and can also occur on the cornea and external genitalia.
bubble_chart Etiology
There are many types of pathogens, with herpes viruses being more common, as well as adenoviruses, coronaviruses, and syncytial viruses. Under an electron microscope, these viruses appear as small round bodies, approximately 180μm in diameter. When overworked, having an allergic constitution, sudden temperature changes, catching a cold, or exposure to certain physical or chemical factors such as mercury, arsenic, bismuth, iodine, etc., the body's resistance is lowered, making it susceptible to this disease. Additionally, acute rhinitis, pneumonia, common cold, malaria, and epidemic meningitis can all be complicated by viral pharyngitis.
bubble_chart Pathological Changes
The lesion causes edema and swelling of epithelial cells, leading to the elevation of the epidermal stratum spinosum and the formation of vesicles containing numerous multinucleated leukocytes and serum. Eosinophilic inclusion bodies are present within the cell nuclei. The vesicles rapidly rupture, forming a shallow ulcer covered with inflammatory cells, red blood cells, or necrotic tissue.
bubble_chart Clinical Manifestations
Clinically, it can be divided into acute and chronic types, with the acute type being more common.
(1) Acute Type: The onset is rapid, initially appearing as pinhead-sized herpes on the pharyngeal and oral mucosa, tonsils, and corners of the mouth, round or oval in shape, isolated or clustered together, quickly rupturing to form shallow ulcers, covered with a pale yellow pseudomembrane, with surrounding mucosa appearing bright red, accompanied by fear of cold, fever, and a burning pain in the throat. Infants and young children may be restless, refuse to eat or drink, and have swollen and tender submandibular lymph nodes.
(2) Chronic Type: More common in adults, a few herpes appear on the pharyngeal and oral mucosa, which after rupturing are covered with a gray-white pseudomembrane, with surrounding mucosa appearing light red, recurring continuously over a long period. There is a slight burning pain in the throat and mouth, with no obvious symptoms.bubble_chart Treatment Measures
1. It is often recommended to gargle with a compound formula borax solution, saline, or 1% hydrogen peroxide; applying 2% aureomycin glycerin or 1% Chinese Gentian Violet to the affected area can promote the healing of the ulcer surface.
2. Pay attention to rest, drink plenty of water, and consume fresh vegetables and nutritious, easily digestible foods to enhance the body's resistance.
3. To prevent secondary infections and shorten the course of the disease, oxytetracycline, midecamycin, or intramuscular injections of penicillin and gentamicin can be taken. For severe systemic symptoms, intravenous antibiotics combined with a certain amount of hormones are often used. For example, intravenous infusion of 8 million units of penicillin + 240,000 units of gentamicin + 5mg of dexamethasone, or 6-8g of cefazolin + 0.4g of amikacin + 5mg of dexamethasone, shows good therapeutic effects and generally no complications. Dosage for children should be appropriately reduced.
4. Chinese medicinals have shown significant effects in treating this disease, divided into internal and external use categories. Medication should be chosen based on the condition, commonly used drugs are as follows:
(1) Heat-clearing: Unprocessed Rehmannia Root, Forsythia, Lonicera, Lophatherum Herb, Akebia Stem, raw licorice, Sophora Root, Isatis Root.
(3) Yin-nourishing: Asparagus Root, Ophiopogon Tuber, Prepared Rehmannia Root, Scrophularia Root, Peony Root, Coastal Glehnia Root, Snakegourd Root.
Additionally, the Department of Stomatology at Shanghai Second Medical College has applied "Red White Powder" for external treatment, with an effective rate of 82.6%. Its composition is: Indigo 30g, sediment of human urine 12g, alum 6g, borneol 4.5g, Cow-Bezoar 0.3g, all ground into fine powder, applied evenly to the local area, 3-4 times daily.
It should be differentiated from aphthous stomatitis, erythema multiforme, necrotizing stomatitis, and herpes zoster.
