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Pharyngitis - sore throat

Pharyngitis, or sore throat, is discomfort, pain, or scratchiness in the throat. It often makes it painful to swallow.

Alternative Names

Pharyngitis - bacterial; Sore throat

Causes

Pharyngitis is caused by swelling in the back of the throat (pharynx) between the tonsils and the (larynx).

Most sore throats are caused by colds, the flu, coxsackie virus or mono (mononucleosis).

Throat anatomy

Bacteria that can cause pharyngitis in some cases.

  • Strep throat is caused by group A streptococcus.
  • Less commonly, bacteria such as gonorrhea, and chlamydia can cause sore throat.

Most cases of pharyngitis occur during the colder months. The illness often spreads among family members and close contacts.

Symptoms

The main symptom is a sore throat.

Other symptoms may include:

Exams and Tests

Your health care provider will perform a physical exam and look at your throat.

A rapid test or throat culture to test for strep throat may be done. Other laboratory tests may be done, depending on the suspected cause.

Treatment

Most sore throats are caused by viruses. Antibiotics do not help viral sore throats. Using these medicines when they are not needed leads to antibiotics not working as well when they are needed.

Sore throat is treated with antibiotics if:

  • A strep test or culture is positive. Your health care provider cannot diagnose strep throat by symptoms or a physical exam alone.
  • A culture for chlamydia or gonorrhea is positive.

Sore throat caused by the flu (influenza) may be helped by antiviral medicines.

The following tips may help your sore throat feel better:

  • Drink warm liquids, such as lemon tea or tea with honey.
  • Gargle several times a day with warm salt water (1/2 tsp of salt in 1 cup of water).
  • Drink cold liquids or suck on fruit-flavored ice pops.
  • Suck on hard candies or throat lozenges. Young children should not be given these products because they can choke on them.
  • Use of a cool-mist vaporizer or humidifier can moisten the air and soothe a dry and painful throat.
  • Try over-the-counter pain medications, such as acetaminophen.

Possible Complications

Complications may include:

  • Ear infection
  • Sinusitis
  • Abscess near the tonsils

When to Contact a Medical Professional

Call your health care provider if:

  • You develop a sore throat that does not go away after several days
  • You have a high fever, swollen lymph nodes in your neck, or a rash

Seek immediate medical care if you have a sore throat and trouble breathing.

References

Wessels MR. Streptococcal pharyngitis. N Engl J Med. 2011;354:648-655.

Frye R, Bailey J, Blevins AE. Clinical inquiries. Which treatments provide the most relief for pharyngitis pain? J Fam Pract. 2011 May;60(5):293-4.

Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012;55(10):e86-e102.

van Driel ML, De Sutter AIM, Keber N, Habraken H, Christiaens T. Different antibiotic treatments for group A streptococcal pharyngitis. Cochrane Database Syst Rev. 2013;4:CD004406. DOI: 10.1002/14651858.CD004406.pub3.

Updated: 2/4/2014

Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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