Sore Throat

What causes a sore throat?

A sore throat can have many causes including:

1. Common viruses, and even the viruses that causemononucleosis (mono) and the flu, can cause a sore throat. Some viruses can also produce blisters in the mouth and throat ("aphthous stomatitis").
2. Breathing through the mouth can produce throat dryness and soreness.
3. Sinus drainage (post nasal drip) may cause a sore throat.
4. A sore throat can also be caused by bacteria. The two most common bacteria to cause a sore throat areStreptococcus (which causes strep throat) andArcanobacterium haemolyticum.Arcanobacterium causes sore throats mainly in young adults and is sometimes associated with a fine red rash.
5. Sore throat appearing after treatment with antibiotics,chemotherapy, or other immune-compromising medications may be due to Candida, commonly known as "thrush."
6. A sore throat lasting for more than two weeks can be a sign of a serious illness, such as throat cancer or AIDS.

What can I do at home for a sore throat?

Generally, sore throats must run their course (exception, strep throat will be addressed below.)

• Salt water gargles, hard candies, sprays for example, Chloraseptic) and lozenges can provide temporary pain relief. (Caution: Lozenges and hard candy are a choking hazard for children. Avoid their use in young children.)
  
• A humidifier may be helpful in relieving symptoms, especially in sore throats caused by mouth breathing and dry air.
  
• Acetaminophen or ibuprofen may help control the pain.
  
• For adults, if your nose is plugged, nasal sprays such as Afrin may be used for two to three days to prevent mouth breathing. It is NOT a good idea to use these products for more than a couple of days; you may become dependent on them.
  
• Other decongestant products, such as Sudafed, may be helpful.
  

If you have health problems such as heart disease or high blood pressure, contact your health care professional before using these products. 

What is strep throat and why is it different?

Strep throat is caused by Streptococcusbacteria, which are the same bacteria that causes rheumatic fever. Only 5%-10% of adult sore throats are caused by strep, whereas about 15%-40% of sore throats in children are related to strep. For this reason, many health care professionals will recommend a "rapid Strep" test for a patient with a sore throat. The "rapid Strep" test can usually be done in the office and takes 15-20 minutes. If the result is negative, it is often followed with a strep culture. If either of these is positive, the sore throat is generally treated with penicillin or another antibiotic.

A major objective of treating strep throat is to prevent the development of rheumatic fever, a serious illness that can cause joint pain and heart valve damage. However, antibiotics do not necessarily speed the healing of the sore throat itself, and antibiotics are of no help for a sore throat unless it is caused by strep. Another strep- related illness, scarlet fever, can cause a rash, but will not cause heart injury or joint pain. For more, please read the Strep Throat article.

When should I seek medical care for a sore throat?

Seek medical care:

1. If you have been in contact with someone with strep throat and you have a sore throat, it is reasonable to have a strep test done.
2. If your sore throat is associated with a fever, swollen "glands" (lymph nodes), or white patches on the back of your throat.
3. If your sore throat is not associated with other cold symptoms (runny nose, watery eyes, sinus congestion).
4. Any sore throat that has a sudden onset and is associated with a fever.
5. If you are having trouble swallowing liquids (pain with swallowing is to be expected with a sore throat).
6. If your sore throat persists for more than a week.
7. If you have a sore throat and the front of your neck is sore and stiff.

What if I have multiple reccurent episodes of strep throat?

There are a number of situations in which a child or adult can have reccurent positive strep tests.

1. The first, and most common, is that the strep bacteria were never eradicated in the first place. The person did not get all of the doses of the medication prescribed. Unless you take a full 7-10 day course of penicillin orerythromycin, the strep throat will not clear. Even missing a dose or two can be a problem.
2. Individuals may be "carriers" of strep (people who have strep in their throats all the time as part of their normal bacteria.) A person may be an asymptomatic carrier (a carrier who does not have symptoms of a sore throat). You may be a carrier, someone in your immediate circle may be a carrier - even your pet dog may be a carrier! The whole family should be tested for strep if it is recurrent.
3. All strep throat bacteria will be killed by penicillin. If penicillin does not get rid of your strep throat, see your doctor. In rare cases, other bacteria in the throat can secrete an enzyme (penicillinase) that breaks down penicillin. This can be overcome by using a drug that is resistant to this enzyme.

Sore Throat At A Glance

• Most sore throats are caused by viruses or mechanical causes (such as mouth breathing) and can be treated successfully at home.
• Any sore throat that has a rapid onset and is associated with a fever or tenderness of the front of the neck may be serious and should be seen by a health care professional.
• Any sore throat that causes you to have difficulty swallowing (not just pain with swallowing) or breathing should be seen by a health care professional.
• Any sore throat that lasts for more than a week should be evaluated by a health care professional.