2023-12-18 09:29:33
by Antonella Sparvoli
In most cases, sore throat has a viral origin and antibiotics are not needed, which are only necessary in bacterial forms. The correct diagnosis is only possible with a throat swab
One of the most insidious ailments of the cold season is a sore throat. When temperatures drop, viruses circulate more and are easier to spread. In most cases it has a viral origin and therefore there is no need to resort to antibiotics at the first burning sensation in the throat. In 70 percent of cases, sore throats have a viral origin – explains Francesco Broccolo, microbiologist at the University of Milan-Bicocca -. Continuous temperature changes, even more than staying in the cold, weaken the ability of our immune system to defend itself from infectious agents. The influenza virus can be involved as well as the many parainfluenza viruses, adenoviruses and cold viruses. As a rule, the viral problem tends to resolve itself within 3-5 days, with the exception of Epstein-Barr virus infection (mononucleosis), the most insidious and persistent form. If you ignore the warning signs, perhaps because you are busy with a thousand daily commitments, it is not uncommon for a bacterial infection to overlap with the viral infection.
The microbiologist points out that there are cases in which sore throats start directly from a bacterial infection. The bacterium most often involved, especially in children, is group A beta-hemolytic Streptococcus, otherwise known as Streptococcus pyogenes.
Sore throat: how to distinguish the bacterial form from the viral one
How are the various forms distinguished? In the case of viral infections – explains Broccolo – it often all starts with a burning sensation between the nose and throat, which can be associated with a runny nose, redness and, in sequence, other ailments from headaches to muscle pain. Fever is usually mild (38 C) or absent, and when there is it tends to resolve in a couple of days. Absolute certainty of the diagnosis can only be obtained by carrying out the so-called throat swab
.
Generally the bacterial forms have a more violent onset with very high fever (40 C). Due to the inflammation, the throat and tonsils become red, the tonsils swell and “plaques” can form which, however, are not an exclusive characteristic of bacterial pharyngitis. Streptococcus pyogenes forms can sometimes also become chronic and cause frequent relapses. Furthermore, if underestimated and not treated properly, pharyngotonsillitis caused by this bacterium can cause various types of complications. However, it is not easy to make a distinction based on the symptoms alone, which is why in case of doubt, a throat swab is useful.
The diagnosis
As mentioned, a certain diagnosis is only possible with the
throat swab. The throat swab allows you to establish the responsible bacterium and set up correct antibiotic therapy. The problem is that it usually takes a couple of days to get the result. For this reason, if a bacterial infection is suspected, it is possible to do a rapid test for type A beta hemolytic Streptococcus in the clinic, especially in children, which gives a fairly reliable response in just 10 minutes. In selected cases, if a bacterial infection is suspected, measuring some substances in the blood, such as C-reactive protein (CRP), may also be useful.
Therapy for sore throat
Doctors and pediatricians insist that the real therapy for sore throat (pharyngitis) is rest to allow the immune system to fight the infection. If necessary, you can then resort to medications
to counteract symptoms as anti-inflammatory and antipyretic. When the sore throat has bacterial origin, antibiotics should be used. If the swab has been performed, a targeted choice is made based on the result of the antibiogram, in other cases the most tolerable and effective antibiotic is chosen, underlines Broccolo. The first mistake to avoid is that of self-prescribing, as often happens. The antibiotic is completely useless if the viral infection – Broccolo points out -. The doctor must prescribe it and it is essential to follow the instructions in terms of dosage, intake times and duration of therapy. If this does not happen, there is a risk of loss of effectiveness, only apparent resolution of the pathology, with an increased risk of relapses; the selection of resistant bacterial strains as well as the increase in side effects in case of overdose due to intakes too close together.
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December 18, 2023 (modified December 18, 2023 | 08:29)
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