Sore throat
A sore throat, or pharyngitis, is characterized by pain and scratchiness in your throat that feels worse when you swallow. Sore throats are most commonly caused by a viral infection such as a cold or the flu.
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Common causes of a sore throat in adults and children
Sore throats in adults
Most sore throats in adults are caused by the viruses of the common cold or flu. Other possible causes include:
- Allergies. Pet dander, molds, dust and pollen often cause a sore throat.
- Chickenpox.
- Dry indoor air.
- Gastroesophageal reflux disease (GERD). A digestive system disorder in which stomach acids back up in the esophagus, irritating the throat.
- HIV infection. A sore throat and other flu-like symptoms sometimes appear soon after someone is infected with HIV.
- Irritants. Includes outdoor air pollution, tobacco smoke and chewing tobacco, chemicals, alcohol and spicy foods.
- Measles.
- Mononucleosis.
- Muscle strain.
- Strep throat. Caused by Streptococcus pyogenes (group A streptococcus) bacteria.
- Tonsillitis. If you still have your tonsils, they may be causing problems and might need to be removed.
- Tumors. Cancerous tumors of the throat, tongue or voice box (larynx) can cause a sore throat.
Sore throats in children
Sore throats are very common in children, and most often they are due to a common cold and get better without treatment. Other possible causes include:
- Croup. Also presents with a harsh, barking cough.
- Ingestion. Your child may suddenly complain of a sore throat after ingesting a household product.
- Peritonsillar or retropharyngeal abscess. A collection of pus either behind the tonsils (peritonsillar) or at the back of the throat (retropharyngeal), requiring medical attention.
- Stomatitis. Caused by viruses, which lead to sores in the mouth and throat. It gets better by itself, but treatments can help alleviate the irritation from the sores.
- Strep throat. A swab test and throat culture will determine if your child has strep.
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Signs and symptoms of a sore throat in adults and children
In adults
Pain and scratchiness in the throat are the main symptoms, but some underlying causes can result in other symptoms, such as:
- Difficulty swallowing.
- Hoarse voice.
- Pain that worsens with swallowing or talking.
- Sore, swollen glands in your neck or jaw.
- Swollen, red tonsils.
- White patches or pus on your tonsils.
In children
Very young children may have a sore throat if they display any of the following:
- Acting very tired.
- Drooling.
- Having pus in the back of the throat.
- Not drinking liquids.
- Trouble swallowing.
Take your child right away to your primary care provider for a proper diagnosis.
When to see your primary care provider for a sore throat
(and how it is diagnosed)
Adults
You should see your provider if you have a sore throat plus any of the following:
- Allergic reaction to antibiotics.
- Blood in your saliva or phlegm.
- Earache.
- Fever higher than 101 F (38.3 C).
- Joint pain.
- Lump in your neck.
- New symptoms develop.
- Problems swallowing.
- Rash.
- Recurring sore throat.
- Swelling in your neck or face.
- Swollen tonsils that make breathing difficult.
- Symptoms don’t improve within a week or within 2–3 days of starting an antibiotic.
- The pain is severe enough to keep you from drinking liquids.
Seek immediate medical attention if you have a sore throat, plus any of the following:
- Feeling dizzy or faint.
- Feeling of doom.
- Skin is blue, purple or gray in color.
- Trouble breathing or talking.
Children
Take your child to your pediatrician or primary care provider if your child displays any of the symptoms of a sore throat, plus any of the following:
- Fever.
- Rash, headache, stomachache or vomiting.
- So sleepy that they are hard to wake or keep awake.
- Stiff neck.
Seek immediate medical care for your child if he/she has:
- Difficulty breathing.
- Difficulty swallowing.
- Extreme drooling, which might indicate an inability to swallow.
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Diagnosing the cause
To diagnose the cause of your sore throat or your child’s sore throat, your primary care provider will take your health history, perform a physical exam and may run some diagnostic tests, such as:
- A blood test to check for mononucleosis.
- A chest X-ray to rule out pneumonia especially if you have a cough.
- A throat swab for a rapid strep test.
Treatment and at-home remedies for a sore throat
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Your primary care provider will develop a personalized treatment plan based on the diagnosis and your symptoms. For a simple viral sore throat, there are several things you can do to relieve your symptoms:
- Avoid alcohol, spicy foods and acidic drinks.
- Don’t smoke, and stay away from secondhand smoke.
- Drink warm liquids to soothe a sore throat and help thin mucus.
- Gargle with warm salt water—1 teaspoon of salt to 8 ounces of warm water.
- Over-the-counter (OTC) pain relievers such as acetaminophen or ibuprofen.
- Throat sprays and lozenges.
- Use a humidifier to keep indoor air moist.
Depending on the cause of your sore throat, your provider may include further steps in your treatment plan. They may prescribe an antibiotic for a bacterial infection such as strep throat.
If tonsillitis is the problem, you may need surgery to remove them, called a tonsillectomy. We recommend this in cases of:
- Multiple severe bouts of tonsillitis in a year.
- Tonsillitis caused by food particles collecting in pouches in the tonsils (cryptic tonsillitis).
- Tonsillitis that causes breathing problems during sleep.
Preventing a sore throat
Prevention is all about avoiding germs and practicing good hygiene by following these suggestions:
- Avoid close contact with sick people and sharing food, cups and utensils.
- Clean telephones, TV remotes and computer keyboards with sanitizing cleanser as often as you can.
- Cough or sneeze into a tissue and throw it away, or into your elbow.
- Wash your hands frequently for 20 seconds at a time, especially after using the bathroom, before eating and after sneezing or coughing. Use alcohol-based hand sanitizers as an alternative.
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References
Center for Disease Control and Prevention (CDC). Sore Throat (https://www.cdc.gov/antibiotic-use/sore-throat.html)
MedlinePlus: National Library of Medicine. Sore Throat (https://medlineplus.gov/sorethroat.html)
MedlinePlus: National Library of Medicine. Pharyngitis – sore throat (https://medlineplus.gov/ency/article/000655.htm)