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Pharyngitis - sore throat

Pharyngitis - bacterial; Sore throat

Pharyngitis, or sore throat, is discomfort, pain, or scratchiness in the throat. It often makes it painful to swallow.

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Causes

Pharyngitis is caused by swelling in the back of the throat (pharynx) between the tonsils and the voice box (larynx).

Most sore throats are caused by colds, the flu, coxsackie virus or mono (mononucleosis).

Bacteria that can cause pharyngitis in some cases:

• Strep throat is caused by group A streptococcus.
• Less commonly, bacterial diseases such as gonorrhea and chlamydia can cause sore throat.

Most cases of pharyngitis occur during the colder months. The illness often spreads among family members and close contacts.

Symptoms

The main symptom is a sore throat.

Other symptoms may include:

• Fever
• Headache
• Joint pain and muscle aches
• Skin rashes
• Swollen lymph nodes (glands) in the neck

Exams and Tests

Your health care provider will perform a physical exam and look at your throat.

A rapid test or throat culture to test for strep throat may be done. Other laboratory tests may be done, depending on the suspected cause. It is important to test for HIV (human immunodeficiency virus) if you have been exposed to HIV and have a sore throat.

Treatment

Most sore throats are caused by viruses. Antibiotics do not help viral sore throats. Using these medicines when they are not needed may lead to antibiotics not working as well when they are needed.

Sore throat is treated with antibiotics if:

• A strep test or culture is positive. Your provider cannot diagnose strep throat by symptoms or a physical exam alone.
• A culture for chlamydia or gonorrhea is positive.

Sore throat caused by the flu (influenza) may be helped by antiviral medicines.

The following tips may help your sore throat feel better:

• Drink soothing liquids. You can either drink warm liquids, such as lemon tea with honey, or cold liquids, such as ice water. You could also suck on a fruit-flavored ice pop.
• Gargle several times a day with warm salt water (1/2 tsp or 3 grams of salt in 1 cup or 240 milliliters of water).
• Suck on hard candies or throat lozenges. Young children should not be given these products because they can choke on them.
• Use of a cool-mist vaporizer or humidifier can moisten the air and soothe a dry and painful throat.
• Try over-the-counter pain medicines, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).

Possible Complications

Complications may include:

• Ear infection
• Sinusitis
• Abscess near the tonsils

When to Contact a Medical Professional

Contact your provider if:

• You develop a sore throat that does not go away after several days
• You have a high fever, swollen lymph nodes in your neck, or a rash

Seek medical care right away if you have a sore throat and trouble breathing.

Related Information

Strep throat
Rheumatic fever

References

Flores AR, Caserta MT. Pharyngitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 59.

Sur DK, Plesa ML. Antibiotic use in acute upper respiratory tract infections. Am Fam Physician. 2022;106(6):628-636. PMID: 36521460 www.ncbi.nlm.nih.gov/pubmed/36521460/.

Tanz RR. Acute pharyngitis. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 409.

van Driel ML, De Sutter AI, Thorning S, Christiaens T. Different antibiotic treatments for group A streptococcal pharyngitis. Cochrane Database Syst Rev. 2021;3:CD004406. PMID: 33728634 www.ncbi.nlm.nih.gov/pubmed/33728634/.

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Review Date: 7/8/2023  

Reviewed By: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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