Galileo | Sore Throat: Causes, Diagnosis & Treatment | Galileo

Sore Throat

Sometimes referred to as: pharyngitis, strep throat (when the cause is bacterial)

Interview between:

  • Andrew Cunningham, MD

  • Steven Winiarski, DO

A sore throat is due to the inflammation of the pharynx and surrounding area. It is most commonly caused by a viral or bacterial infection.

Cases Per Year (US)

12 million yearly doctor visits

General Frequency

Most children and adults experience 3-5 viral infections (including sore throat) per year.

Risk

Low. The vast majority of sore throats resolve within several days. Some bacterial infections, if not treated, can lead to rare complications such as rheumatic heart disease, poststreptococcal glomerulonephritis, and Lemierre’s Syndrome.

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Symptoms and Causes

Along with throat pain, what symptoms generally accompany a sore throat?

Most people experience a sore throat (pharyngitis) at some point in their lives. It typically starts off as a mild discomfort, but can progress to cause significant pain. Along with a sore throat, these infections may cause other symptoms including runny nose, nasal congestion, and cough. 

What typically causes a sore throat?

Pharyngitis can be due to a variety of factors, the most common of which are viral infections, bacterial infections, environmental allergens, and acid reflux. In rare cases, a sore throat can be due to more serious diseases of the throat and surrounding tissues, such as autoimmune diseases and cancer. 

Of all these causes, which is the most common?  

The most common cause of a sore throat is a viral infection, such as those that cause colds and flu-like illnesses. Fortunately, most viral sore throats resolve by themselves in a few days without needing specific treatment.

How common are bacterial infections of the throat?

Bacterial pharyngitis is not as common as a viral infection, but it is an important consideration in certain age groups and populations because it can increase the risk for other diseases such as heart and kidney disease. 

Streptococcus group A is the most common cause of bacterial pharyngitis, comprising 20-30% of sore throats in children and 5-15% of sore throats in adults. This type of infection is commonly referred to as “strep throat.”

Less common causes of bacterial pharyngitis are due to Streptococcus groups C and G and a bacteria called Fusobacterium necrophorum, which can cause a more serious illness called Lemierre’s syndrome.

Are some people at higher risk for contracting strep throat than others?

Streptococcal sore throat typically occurs in children 5-15 years of age and in adults who have school-aged children or are in frequent contact with children. In contrast, Streptococcal pharyngitis is rarely seen in children less than 3 years old. 

Are there any complications of strep throat?

Medical providers treat bacterial pharyngitis with an antibiotic to shorten the duration of symptoms and to decrease the risk of complications. It is important to realize that strep throat is a self-limited illness which resolves by itself in a few days. 

Untreated Streptococcal pharyngitis can, uncommonly, lead to tonsilitis, tonsillar abscess, and infections of the ear and lymph nodes. Treatment with antibiotics can also reduce the risk of developing rarer complications such as acute rheumatic fever and rheumatic heart disease. Antibiotic treatment, however, does not reduce the risk of poststreptococcal glomerulonephritis, an autoimmune disease of the kidney caused by the body’s exposure to the bacteria that can manifest weeks after an infection.

Antibiotic treatment for other, non-streptococcal bacterial infections will also improve symptoms and may decrease the risk of associated complications. Although infection with Streptococcus group C and G have not been conclusively linked to complications beyond the pharynx, infection with Fusobacterium can lead to peritonsillar abscess and, in extremely rare circumstances, a potentially fatal infection of the internal jugular vein called Lemierre’s syndrome.

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Diagnosis

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Treatment

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Prevention

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Andrew Cunningham, MD and Steven Winiarski, DO are both members of the Galileo Clinical Team. Connect with one of our physicians about Sore Throat or any of the many other conditions we treat.

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