Identification of clinical features of viral and bacterial pharyngitis, confirmed by throat swab.

Clinical features of viral and bacterial pharyngitis

Abstract

BACKGROUND & OBJECTIVE:

Sore throat is one of the most common complaints in clinical practice, and pharyngitis often causes it. Although most cases are viral and self-limiting, antibiotics are frequently prescribed unnecessarily due to overlapping clinical features of viral and bacterial infections. Identifying reliable clinical features can help clinicians manage patients appropriately and reduce antibiotic misuse. This study aimed to determine the frequency and clinical features of viral and bacterial pharyngitis and to correlate these findings with throat swab results.

METHODOLOGY:
We conducted a descriptive cross-sectional study in the Department of Otorhinolaryngology, Abbasi Shaheed Hospital, from 15/06/2024 to 30/06/2025. A total of 184 patients were included. We recorded clinical findings using a structured proforma and performed throat swab cultures.

RESULTS:
We diagnosed bacterial and viral pharyngitis in 32 (17%) and 152 (83%) patients, respectively. Among 100 male patients, 84% had viral pharyngitis. The most affected age group was 18–40 years. A total of 96 patients presented after 3 days of illness, of whom 74 had viral pharyngitis and 22 had bacterial infection. High-grade fever, pus points, neutrophilia, and positive throat swab culture were strongly associated with bacterial pharyngitis.

CONCLUSION:
Careful history-taking and clinical examination are essential to distinguish viral from bacterial pharyngitis, ensure appropriate treatment, and reduce unnecessary antibiotic use.