Sore Throat

Infections from viruses or bacteria are the main cause of sore throats and can make it difficult to talk and breathe. Allergies and sinus infections can also contribute to a sore throat. If you have a sore throat that lasts for more than five to seven days, you should see your doctor. While increasing your liquid intake, gargling with warm salt water, or taking over-the-counter pain relievers may help, if appropriate, your doctor may write you a prescription for an antibiotic.

Many sore throats are caused by viruses or bacteria.  Many viral infections are accompanied by a sore throat.  You are probably familiar with many of these: common colds, croup, flu, chicken pox, and “mono” are all common viral illnesses.  Whooping cough and measles are less common causes because of vaccines.  “Mono” is worth noting because it may cause a number of other symptoms that require a doctor’s attention including significant swelling of the glands in the neck and tonsil swelling, occasionally difficulty breathing due to the extreme swelling, and severe fatigue.  The liver and spleen may enlarge so much that it may be necessary to avoid contact sports to prevent injury to these organs.

Strep throat is by far the most common bacterial throat infection.  Unlike viral infections, this should be treated with antibiotics.  It usually infects the tonsils in the back of the mouth but can also infect other tissues in the throat. Children may complain of headaches and stomach pain.  Occasionally abscesses can form in deep spaces in the neck, particularly behind the tonsils.  Deep neck space abscesses are associated with severe pain and swallowing difficulties, fevers, and can cause breathing problems for various reasons.  These are potentially life threatening problems.  Peritonsillar abscesses usually cause ear pain on the side of the abscess.  Other abscesses may be associated with tissue swelling in the neck, difficulty opening your mouth, difficulty turning your neck, or red, hot, pitting swelling of the skin of the neck.  Immediate attention should be sought if you are experiencing these symptoms.

The most dangerous throat infection is epiglottitis, which infects a portion of the larynx (voice box) and causes swelling that closes the airway. Epiglottitis is an emergency condition that requires prompt medical attention. Suspect it when swallowing is extremely painful (causing drooling), when speech is muffled, and when breathing becomes difficult. Epiglottitis may not be obvious just by looking in the mouth. A strep test may overlook this infection.

Other noninfectious cause are allergies, irritants, dry throat, acid reflux, and nasal drainage

Tumors of the throat, tongue, and larynx (voice box) can cause a sore throat with pain radiating to the ear and/or difficulty swallowing. Other important symptoms can include hoarseness, noisy breathing, a lump in the neck, unexplained weight loss, and/or spitting up blood in the saliva or phlegm.

Some of the more worrisome symptoms associated with a sore throat are difficulty (in addition to discomfort) with swallowing, tightening of your breathing, difficulty opening your mouth, associated ear ache, fever > 101F, presence of blood in your phlegm, neck swelling or neck mass.  Increase your liquid intake.

Although bacterial infections like Strep Throat are treated with antibiotics, many sore throats do not require specific treatments.  In such cases, treatment is aimed at relief of the discomfort.  These might include using a humidifier, gargling warm salt water, taking Tylenol or Advil, drinking plenty of fluids especially soothing liquids such as hot tea with honey.