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Sore Throat


Disease: Sore Throat Sore Throat
Category: Infectious diseases
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Disease Definition:

Medically known as pharyngitis, a sore throat is usually caused by a viral infection such as a cold or the flu. Painful swallowing and dry scratchiness are the hallmarks of a sore throat. Sometimes, the first indication that a person is getting sick may be a sore throat.
A sore throat is usually caused by a virus that goes away on its own. In some rare cases, a bacterial infection may be the cause of sore throat, which requires medical care or treatment with antibiotics. Sore throat can be treated with over-the-counter medications and home treatments.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes


Pain when swallowing, breathing or talking and a dry, scratchy or swollen throat are the symptoms of a sore throat.
Usually, an infection that has its own additional symptoms is the cause of sore throat. For instance, someone may also experience sneezing, a runny nose, fever, coughing or body aches in case a cold is the cause of the sore throat.
Although in some cases a sore throat may be caused by something that needs treatment to get better, but usually, within a week, the underlying cause of a sore throat, such as the flu or a cold, gets better on its own.

In case the sore throat is caused by something more serious, such as tonsillitis or strep throat, its signs and symptoms may be:

  • Skin rash
  • Severe throat pain
  • Vomiting
  • A sore throat that doesn't get better on its own or keeps coming back
  • White patches or pus on the tonsils or throat
  • Swollen, red tonsils
  • A high fever; in babies under the age of 6 months a fever over 38.3 C (101 F), and in older children and adults 39.4 C (103 F).
  • Headache
  • Inability to swallow

Although a sore throat may sometimes signal a more serious condition, in most cases, sore throats aren't harmful and go away on their own in five to seven days, despite the fact that they may be uncomfortable.

Some of the signs and symptoms indicating that a person should see a doctor are:

  • Difficulty breathing or swallowing
  • Pus or white patches at the back of the throat
  • In babies under the age of 6 months, a fever over 38.3 C (101 F)
  • In older children and adults, a fever over 39.4 C (103 F)
  • Blood in the saliva or phlegm
  • A sore throat that lasts longer than a week, or a severe sore throat
  • Sunken eyes, decreased urine output, severe weakness or other signs and symptoms of dehydration
  • In young children, excessive drooling
  • Hoarseness or a cough that lasts longer than two weeks
  • Tender or swollen lymph nodes in the neck
  • Sore throats that get better but keep coming back
  • Contact with someone who has been diagnosed with strep throat
  • Skin rashes, which can be a sign of an underlying condition, such as mono (infectious mononucleosis), measles or meningitis.


In a small percentage of cases, a sore throat may be caused by bacterial infections, but usually, sore throats are caused by viruses, the same ones that cause flu and colds. In case someone has had contact with an infected person or used shared objects such as doorknobs, towels, a telephone, utensils or toys, or if they inhale particles that are released into the air when someone coughs or sneezes, viruses and bacteria may enter their body through the mouth or nose. In schools, child care centers and offices, where large numbers of people gather, the germs that cause sore throats can spread easily because they are highly contagious.

Mononucleosis (mono), common cold and flu are the most common viral illnesses that can cause a sore throat.
Additionally, chickenpox; measles; and croup, which is a common childhood illness that causes a harsh, barking cough; are some of the other viral illnesses that may end up causing a sore throat.

Tonsillitis, strep throat and diphtheria, which is a serious respiratory illness quite common in developing countries but rare in industrialized nations, are some of the bacterial infections that may result in a sore throat.

Some of the other conditions that may cause a sore throat may include:

A sore throat may result from the same pet dander, pollens and molds that trigger allergic reactions, including a runny nose and red, swollen eyes.

A dry, sore throat may be the result of breathing through the mouth, usually because of chronic nasal congestion. Additionally, the throat may feel rough and scratchy, especially when the person first wakes up in the morning, due to dry indoor air, particularly in the winter when the rooms are overheated.

Pollution and other irritants:
Ongoing throat irritation may be caused by outdoor air pollution. However, chronic sore throat is usually caused by indoor pollution, especially tobacco smoke. The throat may also become inflamed due to spicy foods, smokeless tobacco and alcohol.

Muscle strain:
After yelling at a concert or sporting event, if a person has gotten a sore throat, he/she has likely strained the throat muscles. Just like straining the muscles of the arms or legs, a person can also strain the muscles in their throat. This may also cause hoarseness of voice, which is a symptom of laryngitis.

Acid GERD (gastroesophageal reflux disease):
When the stomach acid backs up into the esophagus, this condition occurs. Acid is usually blocked from coming up into the esophagus by a circular band of muscle called the lower esophageal sphincter. However, stomach acid may back up and irritate the throat and esophagus in case the sphincter weakens or relaxes abnormally. Throat irritation caused by GERD is far more common in adults than in children. This condition is usually persistent and it doesn't occur with other symptoms of a viral illness. Usually, simple lifestyle changes, such as avoiding foods that cause discomfort, losing weight and not eating right before bed may help prevent or reduce acid reflux. A person may also try over-the-counter or prescription medications in case lifestyle changes don't help.

HIV infection:
Sometimes, when HIV-positive people have a secondary infection, they may develop a chronic sore throat. Some examples of those secondary infections may be oral thrush or cytomegalovirus, which is a common viral infection that can become quite serious in people whose immune systems are weakened.

Smokers and alcohol abusers are at an increased risk of developing tumors of the throat, tongue and voice box. These tumors sometimes cause difficulty swallowing, sore throat and hoarseness, but at other times, they don't cause any signs or symptoms.

Some of the factors that may increase the risk of developing sore throat may be:

Sore throats occur most commonly in children and teens. Children are also more susceptible to developing strep throat, which is the most common bacterial infection that is associated with a sore throat.

Throat irritation may be caused by common household chemicals or particulate matter in the air from burning of fossil fuels.

Throat infections may be caused by drainage from nose or sinus infections.

The best way to steer clear of many viral and bacterial infections is washing the hands carefully and often.



Most of the time, the condition that causes a sore throat isn't serious and goes away on its own without causing any complications. Nevertheless, more serious problems may be caused by these bacterial and viral infections.

Strep throat:
This is a bacterial infection that can cause:

  • Scarlet fever, characterized by a rash
  • Sinus infection (sinusitis)
  • Rheumatic fever, which can damage the heart or other organs.
  • Ear infection
  • Glomerulonephritis, which is inflammation of the kidney
  • Tonsillitis

Some of the signs and symptoms that indicate strep throat may be:

  • Fever
  • Headache
  • Painful swallowing
  • Rash
  • Stomachache and sometimes vomiting, particularly in younger children
  • Tiny red spots on the soft or hard palate, which is the area at the back of the roof of the mouth
  • Red and swollen tonsils, sometimes with white patches or streaks of pus
  • Swollen, tender lymph nodes in the neck

Mono (infectious mononucleosis):
This is a viral infection that may cause complications, such as:  

  • Nerve damage, which could cause paralysis
  • Low levels of platelets, which are the blood cells that are involved in clotting
  • Ruptured spleen or inflammation of the spleen
  • Swollen tonsils, which can obstruct breathing
  • Inflammation of the heart
  • Hepatitis, which is inflammation of the liver
  • Anemia

Some of the signs and symptoms that indicate mono may be:

  • Swollen tonsils
  • Fever
  • Fatigue
  • Skin rash
  • Loss of appetite
  • Night sweats
  • Headache
  • Soft, swollen spleen
  • Swollen lymph nodes in the neck and armpits
  • Weakness
  • Sore throat or strep throat that doesn't get better with antibiotics.


Usually within a week, most sore throats go away on their own. Even though getting extra sleep and increasing fluid intake will help speed recovery, there is no medication for sore throats that are caused by viral infections.
People should avoid caffeine when they’re sick because it can cause dehydration, instead, they should choose fluids, such as broth, water and soups. A person may try sipping warm broth through a straw or sucking on ice chips in case swallowing is painful. A person can eat other foods that are easy to swallow, such as gelatin.

In the past, to cure the infection of sore throat and prevent its dangerous complications such as rheumatic fever, all types of sore throat used to be treated with antibiotics. However, after detecting an increase in antibiotic-resistant strains of bacteria, doctors are prescribing antibiotics much less nowadays. Additionally, antibiotics aren't guaranteed to help because most cases of sore throat aren't caused by bacteria.
However, if someone has been recommended antibiotics, they should make sure to take the entire course to help prevent the infection from coming back and prevent the bacteria from becoming resistant to the medication. Usually, 24 hours after beginning antibiotic treatment when they are no longer contagious, if they feel better and don't have a fever, children can return to school or child care.


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