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Pharyngitis - sore throat

Pharyngitis - bacterial; Sore throat

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

Causes

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

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

Bacteria that can cause pharyngitis in some cases:

  • Strep throat is caused by group A streptococcus.
  • Less commonly, bacterial diseases 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:

  • Fever
  • Headache
  • Joint pain and muscle aches
  • Skin rashes
  • Swollen lymph nodes (glands) in the neck

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 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 soothing liquids. You can either drink warm liquids, such as lemon tea with honey, or cold liquids, such as ice water. You could also suck on a fruit-flavored ice pop.
  • Gargle several times a day with warm salt water (1/2 tsp or 3 grams of salt in 1 cup or 240 milliliters of water).
  • 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 medicines, such as acetaminophen.

Possible Complications

Complications may include:

  • Ear infection
  • Sinusitis
  • Abscess near the tonsils

When to Contact a Medical Professional

Call your 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 medical care right away if you have a sore throat and trouble breathing.

References

Flores AR, Caserta MT. Pharyngitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 59.

Harris AM, Hicks LA, Qaseem A; High Value Care Task Force of the American College of Physicians and for the Centers for Disease Control and Prevention. Appropriate antibiotic use for acute respiratory tract infection in adults: advice for high-value care from the American College of Physicians and the Centers for Disease Control and Prevention. Ann Intern Med. 2016;164(6):425-434. PMID: 26785402 www.ncbi.nlm.nih.gov/pubmed/26785402.

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. PMID: 22965026 www.ncbi.nlm.nih.gov/pubmed/22965026.

Tanz RR. Acute pharyngitis. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 409.

van Driel ML, De Sutter AI, Habraken H, Thorning S, Christiaens T. Different antibiotic treatments for group A streptococcal pharyngitis. Cochrane Database Syst Rev. 2016;9:CD004406. PMID: 27614728 www.ncbi.nlm.nih.gov/pubmed/27614728.

  • Pharyngitis

    Animation

  •  

    Pharyngitis - Animation

    Have you ever gotten a really bad sore throat? So bad that your throat feels raw, like it's been rubbed with sandpaper? It can hurt just to swallow. Pharyngitis is a big word that basically means sore throat. It's a type of sore throat that's caused by inflammation of the pharynx. Your pharynx is a tube in the back of your throat. It sits between your tonsils and your voice box. When bacteria or viruses get into your throat, they can cause an infection that makes your pharynx swollen, tender, and red. This is called pharyngitis. Often, Group A strep bacteria cause pharyngitis, known as strep throat. The main symptom of pharyngitis is a sore throat, but you may also have other signs of an infection, such as a fever, headache, joint and muscle aches, and swollen glands in your neck. Your doctor will notice that your pharynx is swollen and red when looking at your throat. You may also need a swab called a throat culture to make sure you don't have strep throat. If you do test positive for strep throat, your doctor can prescribe an antibiotic to kill off the bacteria. There's another common type of bacteria that can cause throat infections: Fusobacterium necrophorum. I call it F-throat. Antibiotics are important for F-throat. But pharyngitis that's caused by a virus won't get better with antibiotics. You'll just need to take care of yourself and wait for your body to fight off the infection. To soothe a sore throat, drink warm liquids such as tea with honey or lemon. Gargle a few times a day with warm water mixed with about a half-teaspoon of salt. Sleep with a cool-mist vaporizer to keep your throat moist. Popsicles may be soothing. And suck on cough drops or lozenges. If your throat is really raw, you can take an over-the-counter pain reliever. Sore throats are more common during the winter months, so wash your hands often and try to not be too close to people who are sick. If you do get a sore throat, stay home and rest until you feel better, or at least until there's been no fever for 24 hours. Keep washing your hands often so you don't pass the infection to other people in your family. Pharyngitis should go away in a few days, but if it doesn't, call your doctor. Also call if you have a very high fever, a rash, or swollen glands. Get emergency help right away if you have trouble breathing.

  • Throat anatomy

    Throat anatomy - illustration

    Structures of the throat include the esophagus, trachea, epiglottis and tonsils.

    Throat anatomy

    illustration

  • Pharyngitis

    Animation

  •  

    Pharyngitis - Animation

    Have you ever gotten a really bad sore throat? So bad that your throat feels raw, like it's been rubbed with sandpaper? It can hurt just to swallow. Pharyngitis is a big word that basically means sore throat. It's a type of sore throat that's caused by inflammation of the pharynx. Your pharynx is a tube in the back of your throat. It sits between your tonsils and your voice box. When bacteria or viruses get into your throat, they can cause an infection that makes your pharynx swollen, tender, and red. This is called pharyngitis. Often, Group A strep bacteria cause pharyngitis, known as strep throat. The main symptom of pharyngitis is a sore throat, but you may also have other signs of an infection, such as a fever, headache, joint and muscle aches, and swollen glands in your neck. Your doctor will notice that your pharynx is swollen and red when looking at your throat. You may also need a swab called a throat culture to make sure you don't have strep throat. If you do test positive for strep throat, your doctor can prescribe an antibiotic to kill off the bacteria. There's another common type of bacteria that can cause throat infections: Fusobacterium necrophorum. I call it F-throat. Antibiotics are important for F-throat. But pharyngitis that's caused by a virus won't get better with antibiotics. You'll just need to take care of yourself and wait for your body to fight off the infection. To soothe a sore throat, drink warm liquids such as tea with honey or lemon. Gargle a few times a day with warm water mixed with about a half-teaspoon of salt. Sleep with a cool-mist vaporizer to keep your throat moist. Popsicles may be soothing. And suck on cough drops or lozenges. If your throat is really raw, you can take an over-the-counter pain reliever. Sore throats are more common during the winter months, so wash your hands often and try to not be too close to people who are sick. If you do get a sore throat, stay home and rest until you feel better, or at least until there's been no fever for 24 hours. Keep washing your hands often so you don't pass the infection to other people in your family. Pharyngitis should go away in a few days, but if it doesn't, call your doctor. Also call if you have a very high fever, a rash, or swollen glands. Get emergency help right away if you have trouble breathing.

  • Throat anatomy

    Throat anatomy - illustration

    Structures of the throat include the esophagus, trachea, epiglottis and tonsils.

    Throat anatomy

    illustration

Tests for Pharyngitis - sore throat

 
 

Review Date: 7/11/2019

Reviewed By: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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