Some viruses responsible for pharyngitis include rhinovirus, adenovirus, Epstein-Barr virus, herpes simplex virus, influenza virus, parainfluenza virus, coronavirus, enterovirus, respiratory syncytial virus, cytomegalovirus, and human immunodeficiency virus (HIV).
Common symptoms include sore throat, fever, and upper respiratory tract symptoms. Certain signs and symptoms are more suggestive of a viral (rather than bacterial) pharyngitis including conjunctivitis, coryza, cough, diarrhea, or discrete ulcerative lesions.
There is wide overlap between the symptoms caused by different viral pathogens, and there is also significant overlap with symptoms caused by bacterial pathogens. In clinical settings, it is not typically possible to identify the pathogen causing pharyngitis based on symptoms and exam alone.
This condition affects both children and adults, but it is more common in children.
B30.2 – Viral pharyngoconjunctivitis
J02.9 – Acute pharyngitis, unspecified
1532007 – Viral pharyngitis
Differential Diagnosis & Pitfalls
- Group A streptococcal pharyngitis – obtain rapid antigen testing and culture
- Pharyngitis caused by other bacterial pathogens
- Pharyngitis caused by Neisseria gonorrhoeae – in patients with risk factors for sexually transmitted infections
- Lemierre syndrome – pharyngitis classically caused by Fusobacterium necrophorum, presents in healthy young adults with severe sore throat and neck pain, can progress to septic thrombophlebitis of the jugular sheath
- Other head / neck infections, including retropharyngeal abscess and peritonsillar abscess