Pharyngitis and Pharyngeal Space Infections: fever, sore throat, difficulty swallowing

Pharyngeal infections are very common in patients of all ages. They are typically associated with a sore and swollen throat that makes it difficult for the patient to swallow. They may also be accompanied by fevers, swollen lymph nodes, cough, voice hoarseness, and classic symptoms of an upper respiratory infection such as rhinorrhea. The majority of these infections are benign and run a self-limited course, although they often cause patients significant discomfort. A small but still significant number of cases will be due to a more serious process, such as a deep neck space infection. It is important to recognize the clinical and radiographic differences between these patients and patients with simple pharyngitis and triage them appropriately. Failure to recognize and treat patients with more serious infections can have dire consequences and can lead to increased morbidity and mortality. It is also important to recognize that certain populations of patients will be more susceptible to atypical infections. Specific conditions, particularly those that lead to immunocompromise, should prompt the clinician to expand their differential and consider atypical causes of pharyngeal infections.