Some infections are associated with characteristic enanthema, such as palate vesicles and ulcers caused by coxsackievirus-induced herpangina, acute ulcerative stomatitis or pharyngitis caused by HSV, or exudative pharyngitis related to EBV mononucleosis. Pharyngitis occurs with primary HIV infection. Without coryza, pharyngitis caused by group A and other streptococci, Chlamydia , or Mycoplasma is more likely to occur, and appropriate microbiological studies are needed for differentiation. In most cases of viral pharyngitis, treatment is symptomatic, although HSV stomatitis responds to acyclovir. Hoarseness caused by laryngitis frequently occurs during acute viral infections and is more common during infections caused by viruses that invade the lower airways.
Treatment is primarily voice rest.
Laryngeal papillomatosis in older adults can appear as hoarseness. Acute bronchitis manifests itself as a severe or prolonged cough that is usually nonproductive or has scant mucoid sputum. Bronchitis can follow infection by any of the respiratory viruses, especially those affecting the lower airways, and each infection can cause exacerbation of preexisting airway disease, including chronic bronchitis, emphysema, asthma, and cystic fibrosis. Infection may also enhance airway hyperreactivity with increased sensitivity to cold air and pollutants such as smoke. The differential diagnosis of acute viral bronchitis includes bacterial, mycoplasmal, chlamydial, and pertussis infections.