Sore Throat

Is this your symptom?

  • Pain or discomfort of the throat
  • Made worse when you swallow
  • Not caused by an injury to the throat

Causes of Sore Throat

  • Colds. Most sore throats are part of a cold. In fact, a sore throat may be the only symptom for the first 24 hours. Then a cough and runny nose occur.
  • Viral Pharyngitis. Some viruses cause a sore throat without other symptoms. A cough and runny nose don't become part of the illness. An antibiotic won't help.
  • Strep Pharyngitis. Group A Strep is the most common bacterial cause. It accounts for 20% of sore throats without any cold symptoms. Pus is seen on the tonsils. Peak age is 5 to 15 years, but it can occur in adults. An antibiotic is helpful.
  • Mono. Infectious Mono mainly occurs in teens and young adults. The main symptoms are sore throat, fever and widespread swollen lymph nodes. Like Strep, Mono also has pus on the tonsils. Patients with Mono also may have a large spleen. It's located in the upper left side of the stomach. Mono is diagnosed with special blood tests.
  • Post-nasal Drip. Drainage from a sinus infection can cause a sore throat. The throat clearing that goes with the drainage may cause most of the irritation. The sinus infection is more likely to be viral than bacterial.
  • Mouth Breathing. Breathing with the mouth open during sleep can cause a sore throat. After eating breakfast, it often goes away.
  • Abscess of Tonsil (Serious). A bacterial infection of the tonsil can spread to the surrounding tissues. The main symptoms are severe trouble swallowing, fever and one-sided throat pain. It's also hard to fully open the mouth. The peak age is teens, but it also occurs in adults.
  • Epiglottitis (Very Serious). A bacterial infection of the flap of tissue above the vocal cords. It normally covers the windpipe during swallowing. The main symptoms are severe sore throat, drooling, spitting and fever. It can shut off the airway. Needs a 911 response. Used to be most common in children, but due to the uptake of HIB vaccination is less common than it used to be. Can occur at any age.

Strep Throat: When to Suspect

  • Symptoms include sore throat, fever, headache, stomach pain, nausea and vomiting.
  • Cough, hoarseness, red eyes, and runny nose are usually not seen with Strep throat. These symptoms point more to a viral cause.
  • Scarlet fever rash (fine, red, sandpaper-like rash) is highly suggestive of Strep throat.
  • Peak age: 5 to 15 years old, but can occur at any age.
  • If you think you have Strep, contact your doctor.
  • Your doctor will do a Strep test. If the test is positive, they will start treatment. There is no risk from waiting until a Strep test can be done.
  • Standard treatment is with antibiotics by mouth.

When to Call for Sore Throat

Call 911 Now

  • Struggling for each breath, can barely speak, or long pauses between breaths
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Trouble breathing, but not severe
  • Can't open mouth all the way
  • Stiff neck or can't move neck like normal
  • You feel dehydrated (dark urine, very dry mouth)
  • High-risk adult (such as cystic fibrosis or other chronic lung disease)
  • Weak immune system. Examples are: diabetes, sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
  • Fever or chills; feeling hot or shivery
  • You feel very sick
  • You think you need to be seen, and the problem is urgent. Note: a Strep test alone is not urgent; it is recommended within 24 hours.

Contact Doctor Within 24 Hours

  • Throat pain is severe or is worsening
  • Large lymph nodes in the neck
  • Pink rash that's widespread
  • You have white, pus-filled spots on the back of your throat (on the tonsils)
  • Fever lasts more than 3 days
  • Fever returns after being gone more than 24 hours
  • Close contact to a person with Strep within last 7 days
  • Sores on the skin
  • You think you need to be seen, but the problem is not urgent (or you need a Strep test)

Contact Doctor During Office Hours

  • Sore throat is the main symptom and lasts more than 48 hours
  • Sore throat with cold/cough symptoms lasts more than 5 days
  • You are not getting better after 7 days
  • You have other questions or concerns

Self Care at Home

  • Mild sore throat

Care Advice for Mild Sore Throat

  1. What You Should Know About Sore Throats:
    • Most sore throats are just part of a cold and caused by a virus.
    • A cough, hoarse voice or nasal discharge points to a cold as the cause.
    • Most people with a sore throat don't need to see their doctor.
    • Here is some care advice that should help.
  2. Sore Throat Pain Relief:
    • Can sip warm fluids such as tea, chicken broth or apple juice. Some people prefer cold foods such as popsicles or ice cream.
    • Can also suck on hard candy. Butterscotch seems to help.
    • Can also gargle. Use warm water with a little table salt added. A liquid antacid can be added instead of salt. Use Mylanta or the store brand. No prescription is needed.
    • Medicated throat sprays or lozenges are generally not helpful.
  3. Pain Medicine:
    • To help with the pain, take an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil). Ibuprofen works well for this type of pain.
    • Use as needed, but do not take more than the maximum recommended dosage as stated on the package.
    • If you are not sure what to take, ask a pharmacist.
  4. Fever Medicine:
    • For fevers above 102° F (39° C), give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil). Ibuprofen works well for this type of pain.
    • Use as needed, but do not take more than the maximum recommended dosage as stated on the package.
    • If you are not sure what to take, ask a pharmacist.
    • Note: fevers less than 102° F (39° C) are important for fighting infections.
    • For all fevers: stay well hydrated. Drink lots of cold fluids.
  5. Fluids and Soft Diet:
    • Try to drink plenty of fluids.
    • Goal: stay well hydrated.
    • Cold drinks, milk shakes, popsicles, slushes, and sherbet are good choices.
    • Solid Foods: stay with a soft diet. Also avoid foods that need much chewing. Avoid citrus, salty, or spicy foods. Note: fluid intake is much more important than eating any solid foods.
  6. Return to Work:
    • You can return to work after the fever is gone. You should feel well enough to engage in normal activities.
    • Most often, having just a sore throat is not a reason to miss work.
    • If you have Strep throat, you should be on an antibiotic for at least 12 hours.
  7. What to Expect:
    • Most often, sore throats with a viral illness last 4 or 5 days.
  8. Call Your Doctor If:
    • Sore throat is the main symptom and lasts more than 48 hours
    • Sore throat with a cold lasts more than 5 days
    • Fever lasts more than 3 days or goes above 104° F (40° C)
    • You think you need to be seen
    • Your symptoms get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.


Last Reviewed: 10/11/2023 1:01:02 AM
Last Updated: 4/13/2023 1:00:46 AM

Copyright 2023 Schmitt Decisions Logic LLC.

<strong>Scarlet Fever Rash</strong> <p>The photo shows the typical Scarlet Fever rash on the forearm.</p><p>The scarlet fever rash first appears as tiny red bumps on the chest and abdomen that may spread all over the body. Looking like a sunburn, it feels like a rough piece of sandpaper, and lasts about 2-5 days.</p><p>Scarlet fever is a disease caused by the same bacteria (<em>Streptococcus</em>) that causes strep throat. A person with Scarlet fever has a throat that is red and sore, usually a fever, usually swollen glands in the neck, and a Scarlet fever rash.</p>
Scarlet Fever Rash

The photo shows the typical Scarlet Fever rash on the forearm.

The scarlet fever rash first appears as tiny red bumps on the chest and abdomen that may spread all over the body. Looking like a sunburn, it feels like a rough piece of sandpaper, and lasts about 2-5 days.

Scarlet fever is a disease caused by the same bacteria (Streptococcus) that causes strep throat. A person with Scarlet fever has a throat that is red and sore, usually a fever, usually swollen glands in the neck, and a Scarlet fever rash.


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