Sore Throat

There are several different causes of sore throats.

Viral infections: Viruses are the most common cause of sore throats. Several different viruses can cause common colds and upper respiratory infections and include:

• Viruses that cause the flu (influenza)
• Mononucleosis (Epstein-Barr virus)
• Mumps (mumps virus)
• Croup (parainfluenza virus)
• Coxsackie A virus (herpangina)

Bacterial infections: Less common causes of bacterial infections that cause sore throats include:

• Strep throat
• Peritonsillar abscess
• Retropharyngeal abscess
• Diphtheria
• Epiglottitis
• Tonsillitis

Rarely, sexually transmitted diseases (STDs), for example, gonorrhea and chlamydia, can cause a sore throat.

Toxins/Irritants: Many substances can cause sore throats, for example:

• Cigarette smoke
• Air pollution
• Noxious airborne chemicals

• Medical conditions: Health problems, can cause sore throats, for example:
  • Postnasal drip
  • Allergies
  • Cough
  • Gastroesophageal reflux disease (GERD)
  • Tumors
• Intentional or unintentional ingestion: Certain substances, for example, bleach, can cause a sore throat.
• Trauma/Injury: Any direct injury to the throat or neck area can cause a sore throat.
• Foreign body: Sore throats can be caused by foreign bodies stuck in the throat, for example, a bone or piece of food.
• Excessive yelling or screaming: The throat and larynx can cause sore throats due to screaming or excessive yelling.

• Sore throat is a generic term used to describe the symptom of pain or discomfort in the throat. Usually, bacteria, viruses, trauma, and environmental toxins cause throat pain and its associated symptoms and signs. However, not all cases of sore throat are necessarily strep throat.
• Strep throat is a bacterial infection of the throat and tonsils (tonsilitis). Strep throat is specifically caused by group A Streptococcus bacteria. Diagnosis of the cause of strep throat, and the characteristic signs and symptoms, laboratory tests help diagnose the cause of strep throat. Two common tests are used to diagnose the cause of strep throat,
  • the rapid strep test (RADT) and
  • traditional throat culture.

14 signs and symptoms of a sore throat

The signs and symptoms of a sore throat vary depending on the underlying cause. However, the common symptom of a sore throat is the feeling of throat pain and discomfort, which often is worsened by swallowing or while talking. Some people may complain of a scratchy or dry sensation in their throat as well.

Most sore throats are caused by viral infections. In addition to throat pain, common signs and symptoms of a sore throat include:

1. Fever and/or chills
2. Nausea and/or vomiting
3. Body aches
4. Headache
5. Cough
6. Runny nose or nasal congestion
7. Earache
8. Sneezing
9. Weakness
10. Lack of appetite
11. Redness and/or swelling of the tonsils and back of the throat
12. White patchy areas on the tonsils (exudate)
13. Swollen and/or tender lymph nodes in the neck
14. A muffled or hoarse voice

Distinguishing between a sore throat caused by a virus and strep throat can be challenging; however, certain signs and symptoms often can help differentiate between the two. Usually, people with strep throat have signs and symptoms that include red swollen tonsils with white patches (exudate).

Sore throats cause fever and swollen tender lymph nodes in the neck, without the symptoms that usually accompany a cold caused by a virus, for example:

• Cough
• Runny nose
• Nasal congestion
• Sneezing

An evaluation with a doctor may be necessary to confirm the diagnosis of a sore throat while a throat culture (swab taken from the back of the throat) can definitively diagnose the cause of strep throat.

If you are pregnant and your sore throat symptoms are severe, talk to your doctor. Home remedies such as over-the-counter lozenges or saltwater gargles are generally safe. Acetaminophen (Tylenol) can be used for pain or fever.

If symptoms last for more than three days or are associated with a fever see your doctor to be tested for strep throat.

A sore throat may be contagious, depending on the underlying cause. Most sore throats are caused by infections, and under these circumstances, a sore throat can be contagious, whether it is caused by a viral infection (the most common cause) or strep throat. To prevent spreading contagious infections that cause sore throats, preventative measures should be taken to prevent the transmission of the infection.

Most types of these infections are transmitted person-to-person via saliva or nasal secretions commonly spread in airborne respiratory droplets or through direct contact with infected objects (for example, cups or utensils) and infected surfaces. To stop the spread of infections to others:

• Wash your hands frequently
• Cover your mouth when you cough or sneeze
• Do not sharie utensils and cups

To diagnose the cause of a sore throat, the doctor will ask for a detailed history of the illness and perform a physical examination. Because most cases of sore throats are associated with infections, your doctor may order tests to differentiate between a bacterial or viral infection. If your doctor suspects you have strep throat, usually, he or she will take a rapid strep test (swabbing the throat). It takes only minutes for the results, and usually can be obtained during an office visit. A throat culture may be sent to the lab for definitive evaluation of strep throat if the initial rapid strep test is negative. Usually, the results of the culture are available within 24 to 48 hours.

Usually, no further tests are needed, depending on the details of the medical history and the findings on a physical exam. Your doctor may need to order addditional tests to help determine the cause of the sore throat, for example:

• Blood tests
• Radiologic imaging (CT scan or x-ray) of the throat and neck area to evaluate for other various causes of a sore throat (abscess, trauma/injury, tumor, etc).
• In certain cases, a specialist may be recommended depending on the symptoms and presumptive diagnosis (an Ear, Nose, and Throat specialist, for example)..

Various home remedies help soothe throat pain and other symptoms of a sore throat.

• Gargle with warm saltwater (1 teaspoon of salt in 8 ounces of water) and then spit it out.
• Drink warm liquids (such as caffeine-free tea, water with honey, or warm soup broth).
• Consume cold foods, for example, Popsicles or ice cream.
• Use a humidifier to moisten dry air.

If a sore throat is caused by infection, it is important to drink plenty of fluids and to rest in order to prevent dehydration and to allow the body to properly recover.

Various over-the-counter (OTC) medications can help soothe a sore throat. Acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) are analgesics that can provide pain relief. These medications also can reduce fever if the sore throat is caused by infection. Avoid aspirin in children and teenagers, as it has been associated with a serious illness called Reye's syndrome.

Throat lozenges and analgesic throat sprays can help relieve throat pain for some people. (Do not give lozenges to young children, as they are a choking hazard.) O

OTC medications that can help relieve throat pain caused by gastroesophageal reflux disease (GERD) include:

• Antacids
• H2 blockers
• Proton pump inhibitors (PPIs)

If allergies or postnasal drip is causing a sore throat, OTC antihistamines and decongestants may provide symptom relief. If a cough is causing a sore throat, an OTC cough syrup may help diminish the cough.

Zinc lozenges have been found to decrease the duration of symptoms in patients with colds.

There are a number of situations in which a child or adult can have recurrent positive strep tests.

1. The first, and most common, is that the strep bacteria were never eradicated in the first place. The person did not get all of the doses of the medication prescribed. Unless the affected person takes a full 5 to 10-day course of antibiotics, the strep throat will not clear. Even missing a dose or two can be a problem. The patient should take all medication exactly as prescribed, and finish all the medication, even if the sore throat has resolved.
2. Individuals may be asymptomatic carriers of strep (a person who has strep in their throats all the time as part of their normal bacteria, but without symptoms of a sore throat). It may be necessary to test close contacts of a person with recurrent episodes of strep to see if they are carriers.
3. All strep throat bacteria will be killed by penicillin. If penicillin does not cure strep throat, the affected person should see their doctor. In rare cases, other bacteria in the throat can secrete an enzyme (penicillinase) that breaks down penicillin. This can be overcome by using a drug that is resistant to this enzyme.

Most cases of sore throat are caused by a viral infection, so antibiotics in these situations are not needed. Antibiotics do not have any effect on viral infection, as it will need to run its course and your body's natural defenses will typically clear this type of infection.

However, if your sore throat is being caused by a bacterial infection, such as strep throat, then a course of antibiotics will be required to resolve the infection. Complete the full course of antibiotics prescribed, even if you feel better after a few days.

Often, certain causes of sore throats can be prevented since the most common cause are infections. Whether a sore throat is caused by a viral infection or strep throat, you can help prevent getting or transmitting the infection to others.

12 ways to prevent a sore throat

1. Avoid close contact with people who are already ill with a viral upper respiratory tract infection or with strep throat (and other bacterial infections).
2. Practice good personal hygiene habits, such as frequent and thorough hand washing.
3. Avoid sharing personal objects (such as dishes, cups, or utensils).
4. Cover the mouth when coughing or sneezing.
5. Wash your hands often.
6. Avoid touching potentially infected surfaces (computers, doorknobs, or phones) and direct contact with handkerchiefs, napkins, tissues, or towels used by the person with the infection.
7. Taking antibiotics and finishing the full course to treat and decrease transmission of the bacteria causing the infection.

Certain measures to help prevent less common causes of sore throats include:

1. Taking OTC medications to help prevent sore throats if the cause is GERD, allergies, postnasal drip, or cough.
2. Avoid cigarette smoke, pollutants, and noxious airborne chemicals.
3. Taking safety measures and using protective sports equipment to help avoid traumatic injury to the neck and throat.
4. Chewing your food carefully in order to prevent injury to the throat from a foreign body (from a fish bone, for example)
5. Avoiding excessive or prolonged yelling.

Sore throat is a common symptom, and the decision to seek medical care can sometimes be difficult. Though many individuals with a sore throat will have a viral illness that will typically run its course and resolve without problems, certain causes of sore throats may require treatment beyond waiting out the illness and treating it with over-the-counter medications. See a doctor if your sore throat continues for an extended period.

If you have these signs or symptoms, make an appointment with doctor or to the nearest emergency department:

• Severe sore throat
• Drooling
• Difficulty or inability to swallow saliva, food, or liquids
• Difficulty or inability to open your mouth
• Difficulty breathing
• Severe neck pain or neck stiffness
• Redness or swelling of the neck
• Bleeding from the throat, or blood in your saliva/phlegm
• Fever greatern than> 101 F (38.3 C)