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 Sore Throat (Pharyngitis)

Child at doctor visit for a sore throat.

A sore throat is usually a sign of infection from a virus or bacteria. Allergies, sinus infections or acid reflux can also cause sore throats. Pain from an infection is usually worse than discomfort from nasal or reflux problems. Boys Town Ear, Nose and Throat offers insight into different causes and care for sore throat needs.

Common Causes

  • Viruses: The most common cause of a sore throat is a viral infection, such as the common cold, croup or a respiratory flu. The sore throat from a virus will usually go away in 2-4 days although other symptoms may last longer. The viral infection infectious mononucleosis will last significantly longer. Antibiotics are not used for viruses. Increasing fluids such as soups/warm tea and giving acetaminophen (Tylenol) or ibuprofen (Motrin/Advil) is helpful for managing sore throat pain.
  • Bacteria: Streptococcus (strep throat) is the most common cause of bacterial sore throat. It causes about 15% of sore throats, although rates can be higher in winter. Symptoms of strep throat often include fever (greater than 101F), white patches on the throat and swollen neck glands. Headache and stomach pain can also occur. Strep throat is best evaluated with a throat swab test. Rapid strep test results are completed in 15-30 minutes, a 24-48 hour culture is done if the rapid test is negative. Strep is treated with an antibiotic to shorten the illness and prevent complications. It is important to finish the entire antibiotic to keep the sore throat from coming back. Sore throats can also be caused by a bacterial sinus infection when mucus drains from the nose and irritates the throat.
  • Tonsillitis: Tonsillitis is when the tonsils look inflamed or red. It can be caused by a viral or bacterial infection. Pharyngitis means the whole throat/mouth looks abnormal.
  • Allergies: Allergies to molds, dust, pet dander, and pollens can cause a sore throat also, but the sore throat is usually mild and can come and go.  Other causes and symptoms include a stuffy nose from allergies, which can cause nighttime mouth breathing and a sore throat in the morning, post nasal drip from allergies, and the same meds that are used to treat allergies can cause mild sore throats.
  • Gastroesophageal reflux disease (GERD): GERD is a digestive system disorder that causes stomach acid to back up into the esophagus and sometimes into the throat. It can have symptoms of heartburn, hoarseness, cough, soreness and the sensation of a lump in the throat.

Care Tips

  • Increase fluid intake, warm fluids are helpful.
  • Use a humidifier in the bedroom.
  • Older children and adults can gargle with warm salt water (approx. ¼-1/2 teaspoon of salt per cup) helps with pain and swelling.
  • Take over the counter pain/fever relievers such as acetaminophen (Tylenol) or ibuprofen (Motrin/Advil) as needed.
  • Never take leftover antibiotics for this symptom. Antibiotics will have no effect on viruses and may cause side effects or make it harder to find out what is wrong if an illness worsens.

When Should You Seek Medical Attention?

  • Difficulty breathing
  • Difficulty swallowing/drooling
  • Significant swelling on one or both sides of throat or neck
  • Difficulty opening the mouth
  • Ear pain
  • Fever (especially if prolonged or over 102F)
  • Rash
  • Joint pain
  • Frequently recurring sore throat​