Definition

     A sore throat is discomfort, pain, or scratchiness in the throat. A sore throat often makes it painful to swallow. It is a symptom of many conditions, but most often is associated with cold or flu.

Common Causes

• Breathing through the mouth (can cause drying and irritation of the throat)

• Common cold

• Viral pharyngitis

• Influenza

• Strep throat (caused by streptococcal bacteria)

• Infectious mononucleosis

• Fish, chicken bone, or other foreign substance stuck in the throat. (For emergency actions, see choking child or adult or CPR)

• Endotracheal intubation (tube insertion)

• Surgery such as tonsillectomy and adenoidectomy

Symptoms

• Severe difficulty swallowing or breathing

• Excessive drooling in a young child

• A fever, especially 101°F or greater

• Tender or swollen lymph glands in the neck

• Pus in the back of the throat

• A red rash that feels rough, and increased redness in the skin folds

Screening and Diagnostics

     The following diagnostic tests may be performed:

• Complete blood count

• Monospot test (to rule out mononucleosis)

• Throat culture and rapid strep test

Treatment

     Usually, treatment will be delayed until the culture results are known. Doctors will often begin treatment of a sore throat immediately if there is a family history of rheumatic fever, if the patient has scarlet fever, or if rheumatic fever is commonly occurring in the community at the time. Otherwise, antibiotics should NOT be given without a positive strep test (culture or rapid strep test).

     When antibiotics are started, it is important to complete the entire course as directed, even after symptoms improve. Children can return to school or day care 24 hours after antibiotics are started.

     For sore throat caused by infectious mononucleosis, rest and home treatment is recommended.

     For sore throat caused by bacterial tonsillitis, antibiotic treatment may be recommended. Some tonsillitis is viral and will clear up without treatment (surgery is rarely necessary). Recurrent or persistent sore throats without bacterial infection may be due to allergies and require anti-allergy treatment.

Prevention

     Clean your hands frequently, especially before eating. This is a powerful way to help prevent many sore throat infections. You might avoid some sore throats by reducing contact with people with sore throats, but often these people are contagious even before they have symptoms, so this approach is less effective.

     Not too long ago, tonsils were commonly removed in an attempt to prevent sore throats. This is no longer recommended in most circumstances.

     A cool mist vaporizer or humidifier can prevent some sore throats caused by breathing dry air with an open mouth.