Pharyngeal follicular hyperplasia is not a virus, but may be caused by a viral infection that causes inflammation, resulting in a proliferation of lymphoid tissue that manifests as a pharyngeal follicle. For example, acute pharyngitis caused by coxsackievirus, adenovirus and parainfluenza virus has a rapid onset and the initial proliferation phase begins with a dry, burning, rough feeling in the throat, followed by a pronounced sore throat and significant pain when swallowing, which may radiate to the ear.