Sore Throat
Sore throat causes throat clearing, itching, discomfort, and difficulty swallowing. In most cases, it is a symptom of mild conditions such as viral or bacterial infections.
Symptoms and Causes
Sore throat is one of the most common reasons for consultation in pediatrics and family medicine. It presents as discomfort, itching, dryness, throat clearing, and difficulty swallowing. It is not a disease itself but a symptom that occurs in response to inflammation in the area.
In most cases, sore throat is caused by mild illnesses, such as infections, which resolve without complications. However, it can occasionally result from more severe conditions requiring complex treatment.
The intensity of sore throat varies depending on the patient’s overall health and underlying cause. It can occur in isolation or be accompanied by other disease signs, such as fever, cough, nasal congestion, swollen lymph nodes, or white patches.
Symptoms
Common symptoms of sore throat include:
- Itching or burning sensation
- General discomfort worsening with swallowing or speaking
- Irritation
- Difficulty swallowing, even saliva
- Hoarseness
Additional signs may appear when sore throat is caused by an infection, either viral or bacterial:
- Fever
- Tonsillar inflammation
- Redness
- Pus patches
- Cough
- Headache
- Nasal congestion
- Fatigue
- Digestive discomfort
- Cervical lymphadenopathy
Immediate medical attention is required if sore throat is associated with any of the following warning signs:
- Shortness of breath
- Difficulty opening the mouth
- Presence of blood in saliva
- Neck swelling
- Stridor (high-pitched breathing sound)
- Breathing problems
- Drooling
- Palpable mass in the posterior throat
- Muffled voice
Causes
The most frequent causes of sore throat are:
- Viral infection:
- Common cold
- Influenza
- Laryngitis
- Mononucleosis
- Mumps: inflammation of the salivary glands
- Coronavirus
- Bacterial infection: usually caused by streptococcus
- Pharyngitis
- Tonsillitis
- Adenoiditis
- Epiglottitis: inflammation of the epiglottis, the cartilage that covers the trachea during swallowing to prevent food from entering the lungs. It is a severe condition as it may cause airway obstruction.
- Peritonsillar abscess: accumulation of pus beside a tonsil. It is a complication of tonsillitis.
- Retropharyngeal abscess: a serious condition where pus accumulates in the posterior throat.
- Measles
- Chickenpox
- Allergiesto dust, mites, mold, or pollen
- Inhalation of irritants, with tobacco being one of the most frequent
- Exposure to dry environments
- Mouth breathing
- Excessive muscle strain, e.g., from shouting or speaking loudly
- Prolonged speaking
- Gastroesophageal reflux disease (GERD): reflux of stomach acids into the throat causing irritation
- Trauma
- Cancer of the throat, tongue, or larynx
Risk Factors
Sore throat is more frequent in:
- Children aged 3–15 years, as they are more prone to streptococcal infections
- Exposure to tobacco smoke, active or passive
- Allergies
- Continuous exposure to pollutants
- Chronic sinus or respiratory tract infections
- Prolonged time spent in enclosed spaces
- Weakened immune system
Complications
Complications from sore throat are usually due to the underlying disease. Notable ones include:
- Acute otitis media: obstruction of the Eustachian tube and bacterial proliferation in the middle ear
- Sinusitis: inflammation and infection of the paranasal sinuses (air-filled cavities in the skull and face surrounding the nasal cavity)
- Cervical lymphadenitis: infection of neck lymph nodes
- Rheumatic fever: systemic inflammatory disease affecting the heart, joints, skin, and nervous system
- Post-streptococcal glomerulonephritis: inflammation of the glomeruli (kidney filters) following streptococcal infection
- Mastoiditis: infection of the mastoid bone, located behind the ear
- Airway obstruction
Which Specialist Treats Sore Throat?
Sore throat is primarily managed in Family and community medicine and Pediatrics consultations and their sub-specialties, but it can also be addressed by Otorhinolaryngology.
Diagnosis
When a patient presents with sore throat, the specialist performs several tests to identify the underlying cause:
- Direct visualization of the throat using light to assess redness, inflammation, or infection signs such as pus patches
- Palpation of the neck to check for lymph node enlargement
- Pulmonary auscultation: listening to breath sounds with a stethoscope to detect abnormalities
- Throat swab culture: sample taken by swabbing the posterior throat. Laboratory analysis identifies bacterial or other pathogen growth to determine the infectious agent
If a cancerous tumor is suspected as the cause of sore throat, the following studies are performed:
- Laryngoscopy: insertion of a flexible tube with a camera and light through the mouth to examine the throat and larynx
- Imaging tests: CT and MRI provide detailed images of organs, lymph nodes, and tissues to detect cancer cells
- Biopsy: tissue sample from suspicious areas is analyzed in the lab for cancer detection
Treatment
Basic care to relieve sore throat not related to other conditions includes:
- Drinking fluids to keep the throat hydrated; avoid caffeine and alcohol, which contribute to dehydration
- Consuming soothing foods, such as broths or warm milk with honey
- Gargling with saline solution
- Using throat lozenges or pastilles
- Avoiding exposure to irritants, especially smoking
- Using humidifiers to prevent dry environments
- Limiting excessive talking
- Ensuring adequate rest
- Relative rest, particularly during viral infections
Treatment for diseases causing sore throat usually consists of:
- Mild analgesics to relieve discomfort and control fever, commonly paracetamol
- Anti-inflammatory drugs, such as ibuprofen, to reduce swelling and also alleviate pain and fever
- Antibiotics for bacterial infections
- Surgical intervention for trauma-related malformations or cancerous tumors
