Sore throat

Definition

Sore throat is a painful inflammation of the mucous membranes lining the pharynx.

Description

Sore throat is also called pharyngitis. It is a symptom of many conditions, but is most often associated with colds or influenza . Sore throat may be caused by either viral or bacterial infections or environmental conditions. Most sore throats heal without complications, but they should not be ignored, as some develop into serious illnesses.

Sore throats can be either acute or chronic. Acute sore throats are more common than chronic sore throats. They appear suddenly and last from three to about seven days. A chronic sore throat lasts much longer and is a symptom of an unresolved underlying condition or disease, such as a sinus infection.

Transmission

The way in which a sore throat is transmitted depends on the agent causing the sore throat. Viral and bacterial sore throats are usually passed in the same way as the common cold : sneezing, coughing, sharing drinking glasses or silverware, or in any other way germ particles can easily move from one person to another. Some sore throats are caused by environmental factors or allergies . These sore throats cannot be passed from one person to another.

Demographics

Almost everyone gets a sore throat at one time or another, although children in child care or grade school have them more often than adolescents and adults. Sore throats are most common during the winter months when upper respiratory infections (colds) are more frequent.

About 10 percent of children who go to the doctor each year have pharyngitis. Forty percent of the time that children are taken to the doctor with a sore throat, the sore throat is diagnosed as viral. An antibiotic cannot help to cure a virus; a virus has to be left to run its course.

In about 30 percent of the cases for which children are taken to the doctor, bacteria are found to be responsible for the sore throat. Many of these bacterial sore throats are cases of strep throat . Sore throats caused by bacteria can be successfully treated with antibiotics . In about 40 percent of these cases of pharyngitis, it is never clear what caused the sore throat. In these cases it is possible that the virus or bacteria was not identified, or that other factors such as environment or post-nasal drip may have been responsible.

Causes and symptoms

Sore throats have many different causes, and may or may not be accompanied by cold symptoms, fever , or swollen lymph glands. Proper treatment depends on understanding the cause of the sore throat.

Viral sore throat

Viruses cause most sore throats. Cold and flu viruses are the main culprits. These viruses cause an inflammation in the throat and occasionally the tonsils (tonsillitis ). Cold symptoms usually accompany a viral sore throat. These can include a runny nose, cough , congestion, hoarseness, conjunctivitis , and fever. The level of throat pain varies from uncomfortable to excruciating, when it is painful for the patient to eat, breathe, swallow, or speak.

Another group of viruses that causes sore throat are the adenoviruses. These may also cause infections of the lungs and ears. In addition to a sore throat, symptoms that accompany an adenovirus infection include cough, runny nose, white bumps on the tonsils and throat, mild diarrhea , vomiting , and a rash. The sore throat lasts about one week.

A third type of virus that can cause severe sore throat is the coxsackie virus. It can cause a disease called herpangina. Although anyone can get herpangina, it is most common in children up to age 10 and is more prevalent in the summer or early autumn. Herpangina is sometimes called summer sore throat.

Three to six days after being exposed to the coxsackie virus, an infected person develops a sudden sore throat that is accompanied by a substantial fever, usually between 102–104°F (38.9–40°C). Tiny grayish-white blisters form on the throat and in the mouth. These fester and become small ulcers. Throat pain is often severe, interfering with swallowing. Children may become dehydrated if they are reluctant to eat or drink because of the pain. In addition, children with herpangina may vomit, have abdominal pain, and generally feel very ill.

One other common cause of a viral sore throat is mononucleosis. Mononucleosis occurs when the Epstein-Barr virus infects one specific type of lymphocyte. The infection spreads to the lymphatic system, respiratory system, liver, spleen, and throat. Symptoms appear 30–50 days after exposure.

Mononucleosis, sometimes called the kissing disease, is extremely common. It is estimated that by the age of 35–40, 80–95 percent of Americans will have had mononucleosis. Often, symptoms are mild, especially in young children, and are diagnosed as a cold. Since symptoms are more severe in adolescents and adults, more cases are diagnosed as mononucleosis in this age group. One of the main symptoms of mononucleosis is a severe sore throat.

Although a runny nose and cough are much more likely to accompany a sore throat caused by a virus than one caused by a bacteria, there is no absolute way to tell what is causing the sore throat without a laboratory test.

Bacterial sore throat

Fewer sore throats are caused by bacteria than are caused by viruses. The most common bacterial sore throat results from an infection by group A Streptococcus. This type of infection is commonly called strep throat. Anyone can get strep throat, but it is most common in school age children.

Noninfectious sore throat

Not all sore throats are caused by infection. Postnasal drip can irritate the throat and make it sore. It can be caused by hay fever and other allergies that irritate the sinuses. Environmental and other conditions, such as breathing secondhand smoke, breathing polluted air or chemical fumes, or swallowing substances that burn or scratch the throat can also cause pharyngitis. Dry air, like that in airplanes or from forced hot air furnaces, can make the throat sore. Children who breathe through their mouths at night because of nasal congestion often get sore throats that improve as the day progresses. Sore throat caused by environmental conditions is not contagious.

When to call the doctor

If the child has had a sore throat and fever for more than 24 hours, a doctor should be contacted so a strep test can be performed. Identifying and treating strep throat within about a week is vital to preventing rheumatic fever . If the child has had a sore throat, even without fever, for more than 48 hours, the doctor should be consulted. If the child has trouble swallowing or breathing, or is drooling excessively (in small children), emergency medical attention should be sought immediately.

Diagnosis

It is easy for people to tell if they have a sore throat, but difficult to know what has caused it without laboratory tests. Most sore throats are minor and heal without any complications. A small number of bacterial sore throats do develop into serious diseases. Because of this, it is advisable to see a doctor if a sore throat lasts more than a few days or is accompanied by fever, nausea , or abdominal pain.

Diagnosis of a sore throat by a doctor begins with a physical examination of the throat and chest. The doctor will also look for signs of other illness, such as a sinus infection or bronchitis . Since both bacterial and viral sore throat are contagious and pass easily from person to person, the doctor will seek information about whether the patient has been around other people with flu, sore throat, colds, or strep throat. If it appears that the patient may have strep throat, the doctor will do laboratory tests.

If mononucleosis is suspected, the doctor may do a mono spot test to look for antibodies indicating the presence of the Epstein-Barr virus. The strep test is inexpensive, takes only a few minutes, and can be done in a physician's office. An inexpensive blood test can also determine the presence of antibodies to the mononucleosis virus.

Treatment

Effective treatment varies depending on the cause of the sore throat. Viral sore throats are best left to run their course without drug treatment, because antibiotics have no effect on a viral sore throat. They do not shorten the length of the illness, nor do they lessen the symptoms.

Sore throat caused by streptococci or another bacteria must be treated with antibiotics. Penicillin is the preferred medication, although other antibiotics are also effective if the child is allergic to penicillin. Oral penicillin must be taken for 10 days. Patients need to take the entire amount of antibiotic prescribed, even after symptoms of the sore throat improve. If it is unlikely that the parent will be able to ensure that the child will take the full course of antibiotics, a one-time injection of antibiotics can be administered instead. Cessation of the antibiotic early can lead to a return of the sore throat.

Because a virus causes mononucleosis, there is no specific drug treatment available. Rest, a healthy diet, plenty of fluids, limiting heavy exercise and competitive sports , and treatment of aches with acetaminophen (Datril, Tylenol, Panadol) or ibuprofen (Advil, Nuprin, Motrin, Medipren) will help the illness pass. Nearly 90 percent of mononucleosis infections are mild. The infected person does not normally get the disease again.

In the case of chronic sore throat, it is necessary to treat the underlying disease to heal the sore throat. If a sore throat is caused by environmental factors, the aggravating stimulus should be eliminated from the sufferer's environment.

Home care for sore throat

Regardless of the cause of a sore throat, there are some home care steps that people can take to ease their discomfort. These include:

• taking acetaminophen or ibuprofen for pain (aspirin should not be given to children because of its association with increased risk for Reye's syndrome , a serious disease)
• gargling with warm double strength tea or warm salt water made by adding 1 tsp of salt to 8 oz (237 ml) of water
• drinking plenty of fluids, but avoiding acid juices such as orange juice, which can irritate the throat (sucking on popsicles is a good way to get fluids into children)
• eating soft, nutritious foods like noodle soup and avoiding spicy foods
• resting until the fever is gone, then resuming strenuous activities gradually
• using a room humidifier to make sore throat sufferers more comfortable
• using antiseptic lozenges and sprays with caution, as they may aggravate the sore throat rather than improve it

Alternative treatment

Alternative treatment focuses on easing the symptoms of sore throat using herbs and botanical medicines.

• Aromatherapists recommend inhaling the fragrances of the essential oils of lavender (Lavandula officinalis ), thyme (Thymus vulgaris ), eucalyptus (Eucalyptus globulus ), sage (Salvia officinalis ), and sandalwood.
• Ayurvedic practitioners suggest gargling with a mixture of water, salt, and tumeric (Curcuma longa ) powder or astringents such as alum, sumac, sage, and bayberry (Myrica spp.).
• Herbalists recommend taking osha root (Ligusticum porteri ) internally for infection or drinking ginger (Zingiber officinale ) or slippery elm (Ulmus fulva ) tea for pain.
• Homeopaths may treat sore throats with superdilute solutions of Lachesis, Belladonna, Phytolacca, or yellow jasmine (Gelsemium ).

Nutritional concerns

Nutritional recommendations include zinc lozenges every two hours along with vitamin C with bioflavonoids, vitamin A, and beta-carotene supplements. Although it may hurt to swallow, it is very important that the child does not become dehydrated. Sucking on popsicles or drinking warm broth can help. If the child shows any signs of dehydration he or she should be taken to the doctor.

Prognosis

Sore throat caused by a viral infection generally clears up on its own within one week with no complications. The exception is mononucleosis. Ninety percent of cases of mononucleosis clear up without medical intervention or complications, so long as dehydration does not occur. In young children, the symptoms may last only a week, but in adolescents the symptoms usually last longer. In all age groups, fatigue and weakness may continue for up to six weeks after other symptoms disappear.

In rare cases of mononucleosis, breathing may be obstructed because of swollen tonsils, adenoids, and lymph glands. If this happens, the individual should seek emergency medical care immediately.

Patients with bacterial sore throat begin feeling better about 24 hours after starting antibiotics. Untreated strep throat has the potential to cause scarlet fever , kidney damage, or rheumatic fever. Scarlet fever causes a rash and can cause high fever and convulsions. Rheumatic fever causes inflammation of the heart and damage to the heart valves. Taking antibiotics within the first week of a strep infection will prevent these complications. People with strep throat remain contagious until they have taken antibiotics for 24 hours.

Prevention

There is no way to prevent a sore throat; however, the risk of getting one or passing one on to another person can be minimized by:

• washing hands well and frequently
• avoiding close contact with someone who has a sore throat
• not sharing food and eating utensils with anyone
• staying out of polluted air

Parental concerns

Viral sore throats usually resolve themselves fairly quickly although they may be very uncomfortable. If the child has a fever and sore throat for more than 24 hours it may be a sign of a bacterial infection and the child should be taken to the doctor. Prompt treatment with antibiotics for strep throat is important because it can prevent rheumatic fever, a serious disease that can cause damage to the heart.

KEY TERMS

Antigen —A substance (usually a protein) identified as foreign by the body's immune system, triggering the release of antibodies as part of the body's immune response.

Lymphocyte —A type of white blood cell that participates in the immune response. The two main groups are the B cells that have antibody molecules on their surface and T cells that destroy antigens.

Pharynx —The throat, a tubular structure that lies between the mouth and the esophagus.

See also Common cold; Mononucleosis.

Resources

PERIODICALS

"Coughs, Colds, and Sore Throat." Practice Nurse v.26, i.2 (July 25, 2003): 38.

Dinelli, D.L. "Sore Throat and Difficulty Breathing." American Family Physician 63, no. 11 (June 1, 2001): 2255.

"Sore Throat." The Journal of the American Medical Association 291, no. 13 (April 7, 2004): 1664.

Vincent, Miriam T., Celestin, Nadhia, Hussain, Aneela N. "Pharyngitis." American Family Physician 69, no. 6 (March 15, 2004): 1465.

Tish Davidson, A.M.

Sore throat

Definition

Sore throat, also called pharyngitis, is a painful inflammation of the back of the throat. It is a symptom of many conditions, but most often is associated with colds or influenza . Sore throat may be caused by either viral or bacterial infections or by environmental conditions. Most sore throats heal without complications, but they should not be ignored because some develop into serious illnesses.

Description

Almost everyone gets a sore throat at one time or another, although children in child care or grade school have them more often than adolescents and adults. Sore throats are most common during the winter months when upper respiratory infections (colds) and influenza are more frequent.

Sore throats can be either acute or chronic. Acute sore throats are the more common. They may appear suddenly and last approximately three to about seven days. A chronic sore throat that is still present after three weeks may be a symptom of an unresolved underlying condition or disease, such as a sinus infection or mononucleosis .

Causes & symptoms

Sore throats have many different causes, and may or may not be accompanied by cold symptoms, fever , or swollen lymph glands. Proper treatment depends on identifying the cause.

Viral sore throat

Viruses cause 90–95% of all sore throats. Cold and flu viruses are the main culprits. These viruses cause an inflammation in the throat and occasionally the tonsils (tonsillitis ). Cold symptoms usually accompany a viral sore throat. These can include a runny nose, cough , congestion, hoarseness, conjunctivitis , fever, and swollen lymph nodes in the neck. The level of throat pain varies from uncomfortable to excruciating, when it is painful for the patient to eat, breathe, swallow, or speak.

Another group of viruses that cause sore throat are the adenoviruses. These may also cause infections of the lungs and ears. In addition to a sore throat, symptoms that accompany an adenovirus infection may include cough, runny nose, white bumps on the tonsils and throat, mild diarrhea, vomiting , and a rash. The sore throat lasts about one week.

A third type of virus that can cause severe sore throat is the coxsackie virus. It can cause a disease called herpangina. Although anyone can get herpangina, it is most common in children up to age 10 and is more prevalent in the summer or early autumn. Herpangina is sometimes called summer sore throat.

Three to six days after being exposed to the virus, an infected person develops a sudden sore throat that is usually accompanied by a fever usually between 102–104°F (38.9–40°C). Tiny grayish-white blisters form on the throat and in the mouth. These fester and become small ulcers. Throat pain is often severe, interfering with swallowing. Children may easily become dehydrated if they are reluctant to eat or drink because of the pain. In addition, people with herpangina may vomit, have abdominal pain, and generally feel ill and miserable.

Another common cause of a viral sore throat is mononucleosis. Mononucleosis occurs when the Epstein-Barr virus infects one specific type of lymphocyte. The infection may spread to the lymphatic system, respiratory system, liver, spleen, and throat. Symptoms appear 30–50 days after exposure.

Mononucleosis, sometimes called the kissing disease, is extremely common in young adults. It is estimated that by the age of 35–40, 80–95% of Americans will have had mononucleosis. Often, symptoms are mild, especially in young children, and are diagnosed as a cold. Since symptoms are more severe in adolescents and adults, more cases are diagnosed as mononucleosis in this age group. One of the main symptoms of mononucleosis is a severe sore throat.

Although a runny nose and cough are much more likely to accompany a sore throat caused by a virus than one caused by a bacteria, there is no absolute way to tell what is causing the sore throat without a laboratory test. Viral sore throats are contagious and are passed directly from person to person by coughing and sneezing .

Bacterial sore throat

From 5–10% of sore throats are caused by bacteria. The most common bacterial sore throat results from an infection by group A Streptococcus. This type of infection is commonly called strep throat , or GABHS pharyngitis. The acronym stands for "Group A beta-hemolytic streptococci." Anyone can get strep throat, but it is most common in school age children. Since three is a low risk of strep throat invading and damaging heart valves (rheumatic fever ), it is important to see a doctor who may prescribe antibiotics to eliminate the risk.

Pharyngeal gonorrhea , a sexually transmitted bacterial disease, causes a severe sore throat. Gonorrhea in the throat is transmitted by having oral sex with an infected person.

Noninfectious sore throat

Not all sore throats are caused by infection. Post-nasal drip from allergies and airborne irritants can cause sore throat. It can be caused by hay fever and other allergies that irritate the sinuses. Environmental and other conditions, such as heavy smoking or breathing secondhand smoke, breathing polluted air or chemical fumes, or swallowing substances that burn or scratch the throat can also cause pharyngitis. Dry air, like that in airplanes or from forced hot air furnaces, can make the throat sore. People who breathe through their mouths at night because of nasal congestion often get sore throats that improve as the day progresses. Sore throat caused by environmental conditions is not contagious.

Diagnosis

It is easy for people to tell if they have a sore throat, but difficult to diagnose its cause without seeing a doctor and having laboratory tests. Most sore throats are minor and heal without any complications. A small number of bacterial sore throats develop into serious diseases. It is advisable to see a doctor if a sore throat lasts more than a few days or is accompanied by fever, nausea , or abdominal pain.

Diagnosis of a sore throat by a doctor begins with a physical examination of the throat and chest. The doctor will also look for signs of other illness, such as a sinus infection or bronchitis . Since both bacterial and viral sore throats are contagious and pass easily from person to person, the doctor will seek information about whether the patient has been around other people with flu, sore throat, colds, or strep throat. If it appears that the patient may have strep throat, the doctor will do laboratory tests.

One test that doctors are using more often in diagnosing a sore throat is the rapid antigen test. While a throat culture may require 2 days for the laboratory to identify the causative organism, a rapid antigen test gives results in a few hours.

If mononucleosis is suspected, the doctor may do a Monospot test to look for antibodies indicating the presence of the Epstein-Barr virus. The test in inexpensive, takes only a few minutes, and can be done in a physician's office. An inexpensive blood test can also determine the presence of antibodies to the mononucleosis virus.

Treatment

Effective treatment varies depending on the cause of the sore throat. As frustrating as it may be to the patient,

viral sore throat is best left to run its course without drug treatment. Antibiotics have no effect on a viral sore throat. They do not shorten the length of the illness, nor do they lessen the symptoms.

Treatment uses antiviral plants and herbs and vitamins to boost immunity and speed recovery.

• Aromatherapists recommend inhaling the fragrances of essential oils of lavender (Lavandula officinalis), thyme (Thymus vulgaris ), eucalyptus (Eycalyptus globulus ), sage (Salvia officinalis ), and sandalwood.
• Ayurvedic practitioners suggest gargling with a mixture of water, salt, and turmeric (Curcuma longa ) powder or astringents such as alum, sumac, sage, and bayberry (Myrica spp.).
• Herbalists recommend taking osha root (Ligusticum porteri ) internally for infection, or drinking ginger (Zingiber officinale ) or slippery elm (Ulmus fulva ) tea for pain.
• Homeopaths may treat sore throats with superdilute solutions of Lachesis, Belladonna, or Phytolacca, yellow jasmine (Gelsemium ), or mercury (Mercurius).
• Nutritional recommendations include zinc lozenges every two hours along with vitamin C with bioflavonoids, vitamin A , and beta-carotene supplements.

In the case of chronic sore throat, it is necessary to treat the underlying disease to heal the sore throat. If a sore throat is caused by environmental factors, the aggravating stimulus should be eliminated from the sufferer's environment. In the case of chronic sore throat in a child, the doctor may recommend a tonsillectomy (surgical removal of the tonsils).

Home care for sore throat

Regardless of the cause of a sore throat, there are some home care steps that people can take to ease their discomfort. These include:

• Gargling with warm double strength tea or warm salt water made by adding one teaspoon of salt to 8 oz of water.
• Drinking plenty of fluids, but avoiding acid juices like orange juice, which can irritate the throat. Sucking on popsicles is a good way to get fluids into children.
• Eating soft, nutritious foods like noodle soup and avoiding spicy foods.
• Refraining from smoking.
• Resting until the fever is gone, then resuming strenuous activities gradually.
• A room humidifier may make sore throat sufferers more comfortable.
• Antiseptic lozenges and sprays may aggravate the sore throat rather than improve it.

Allopathic treatment

Sore throat caused by a streptococci or another bacteria must be treated with antibiotics. Penicillin is the preferred medication. Oral penicillin must be taken for 10 days. Patients need to take the entire amount of antibiotic prescribed, even after symptoms of the sore throat improve. Stopping the antibiotic early can lead to a return of the sore throat. Sometimes a single injection of long-acting penicillin G is given instead of 10 days of oral treatment. These medications generally cost under $15.

Because mononucleosis is caused by a virus, there is no specific drug treatment available. Rest, a healthy diet, plenty of fluids, limiting heavy exercise and competitive sports, and treatment of aches with acetaminophen (Datril, Tylenol, Panadol) or ibuprofen (Advil, Nuprin, Motrin, Medipren) are the prescribed treatments. Nearly 90% of mononucleosis infections are mild. The infected person does not normally get the disease again.

Aspirin should not be given to children because of its association with increased risk for Reye's Syndrome, a serious disease.

Expected results

Sore throat caused by a viral infection generally clears up on its own within one week with no complications. The exception is mononucleosis. Ninety percent of cases of mononucleosis clear up without medical intervention or complications, so long as dehydration does not occur. In young children the symptoms may last only a week, but in adolescents the symptoms last longer. Adults over age 30 have the most severe and long lasting symptoms. Adults may take up to six months to recover. In all age groups fatigue and weakness may continue for up to six weeks after other symptoms disappear.

In rare cases of mononucleosis, breathing may be obstructed because of swollen tonsils, adenoids, and lymph glands. If this happens, the patient should immediately seek emergency medical care.

Patients with bacterial sore throat begin feeling better about 24 hours after starting antibiotics. Untreated strep throat has the potential to cause scarlet fever , kidney damage, or rheumatic fever. Scarlet fever causes a rash, and can cause high fever and convulsions. Rheumatic fever causes inflammation of the heart and damage to the heart valves. Taking antibiotics within the first week of a strep infection will prevent these complications. People with strep throat remain contagious until after they have been taking antibiotics for 24 hours.

Prevention

There is no way to prevent a sore throat; however, the risk of getting one or passing one on to another person can be minimized by:

• Washing hands with warm water and soap frequently.
• Maintaining a balanced life with adequate sleep, nutrition , and personal fulfillment.
• Avoiding close contact with someone who has a sore throat.
• Not sharing food and eating utensils with anyone.
• Not smoking.
• Optimizing the functioning of the immune system by exercising and eating such immune-boosting foods as carrots, yams, shiitake mushrooms, etc.
• Avoiding sources of air pollution.

Resources

BOOK

Berkow, Robert. The Merck Manual of Diagnosis and Therapy Rahway, NJ: Merck Research Laboratories, 1992.

PERIODICALS

Larkin, Marilynn. "A Single, Rapid Test Suffices for Pharyngitis Diagnosis in High-Risk Patients." Lancet 358 (December 8, 2001): 1969.

National Institute of Allergy and Infectious Diseases. Infectious Mononucleosis Fact Sheet http://www.niaid.nih.gov/factsheets/infmono.htm (September 1997).

Kathleen Wright

Rebecca J. Frey, PhD

Sore Throat

Definition

Sore throat, also called pharyngitis, is a painful inflammation of the mucous membranes lining the pharynx. It is a symptom of many conditions, but most often is associated with colds or influenza. Sore throat may be caused by either viral or bacterial infections or environmental conditions. Most sore throats heal without complications, but they should not be ignored because some develop into serious illnesses.

Description

Almost everyone gets a sore throat at one time or another, although children in child care or grade school have them more often than adolescents and adults. Sore throats are most common during the winter months when upper respiratory infections (colds) are more frequent.

Sore throats can be either acute or chronic. Acute sore throats are the more common. They appear suddenly and last from three to about seven days. A chronic sore throat lasts much longer and is a symptom of an unresolved underlying condition or disease, such as a sinus infection.

Causes and symptoms

Sore throats have many different causes, and may or may not be accompanied by cold symptoms, fever, or swollen lymph glands. Proper treatment depends on understanding the cause of the sore throat.

Viral sore throat

Viruses cause 90-95% of all sore throats. Cold and flu viruses are the main culprits. These viruses cause an inflammation in the throat and occasionally the tonsils (tonsillitis ). Cold symptoms almost always accompany a viral sore throat. These can include a runny nose, cough, congestion, hoarseness, conjunctivitis, and fever. The level of throat pain varies from uncomfortable to excruciating, when it is painful for the patient to eat, breathe, swallow, or speak.

Another group of viruses that cause sore throat are the adenoviruses. These may also cause infections of the lungs and ears. In addition to a sore throat, symptoms that accompany an adenovirus infection include cough, runny nose, white bumps on the tonsils and throat, mild diarrhea, vomiting, and a rash. The sore throat lasts about one week.

A third type of virus that can cause severe sore throat is the coxsackie virus. It can cause a disease called herpangina. Although anyone can get herpangina, it is most common in children up to age ten and is more prevalent in the summer or early autumn. Herpangina is sometimes called summer sore throat.

Three to six days after being exposed to the virus, an infected person develops a sudden sore throat that is accompanied by a substantial fever usually between 102-104°F (38.9-40°C). Tiny grayish-white blisters form on the throat and in the mouth. These fester and become small ulcers. Throat pain is often severe, interfering with swallowing. Children may become dehydrated if they are reluctant to eat or drink because of the pain. In addition, people with herpangina may vomit, have abdominal pain, and generally feel ill and miserable.

One other common cause of a viral sore throat is mononucleosis. Mononucleosis occurs when the Epstein-Barr virus infects one specific type of lymphocyte. The infection spreads to the lymphatic system, respiratory system, liver, spleen, and throat. Symptoms appear 30-50 days after exposure.

Mononucleosis, sometimes called the kissing disease, is extremely common. It is estimated that by the age of 35-40, 80-95% of Americans will have had mononucleosis. Often, symptoms are mild, especially in young children, and are diagnosed as a cold. Since symptoms are more severe in adolescents and adults, more cases are diagnosed as monomucleosis in this age group. One of the main symptoms of mononucleosis is a severe sore throat.

Although a runny nose and cough are much more likely to accompany a sore throat caused by a virus than one caused by a bacteria, there is no absolute way to tell what is causing the sore throat without a laboratory test. Viral sore throats are contagious and are passed directly from person to person by coughing and sneezing.

Bacterial sore throat

From 5-10% of sore throats are caused by bacteria. The most common bacterial sore throat results from an infection by group A Streptococcus. This type of infection is commonly called strep throat. Anyone can get strep throat, but it is most common in school age children.

Pharyngeal gonorrhea, a sexually transmitted bacterial disease, causes a severe sore throat. Gonorrhea in the throat is transmitted by having oral sex with an infected person.

Noninfectious sore throat

Not all sore throats are caused by infection. Postnasal drip can irritate the throat and make it sore. It can be caused by hay fever and other allergies that irritate the sinuses. Environmental and other conditions, such as heavy smoking or breathing second-hand smoke, heavy alcohol consumption, breathing polluted air or chemical fumes, or swallowing substances that burn or scratch the throat can also cause pharyngitis. Dry air, like that in airplanes or from forced hot air furnaces, can make the throat sore. People who breathe through their mouths at night because of nasal congestion often get sore throats that improve as the day progresses. Sore throat caused by environmental conditions is not contagious.

Diagnosis

It is easy for people to tell if they have a sore throat, but difficult to know what has caused it without laboratory tests. Most sore throats are minor and heal without any complications. A small number of bacterial sore throats do develop into serious diseases. Because of this, it is advisable to see a doctor if a sore throat lasts more than a few days or is accompanied by fever, nausea, or abdominal pain.

Diagnosis of a sore throat by a doctor begins with a physical examination of the throat and chest. The doctor will also look for signs of other illness, such as a sinus infection or bronchitis. Since both bacterial and viral sore throat are contagious and pass easily from person to person, the doctor will seek information about whether the patient has been around other people with flu, sore throat, colds, or strep throat. If it appears that the patient may have strep throat, the doctor will do laboratory tests.

If mononucleosis is suspected, the doctor may do a mono spot test to look for antibodies indicating the presence of the Epstein-Barr virus. The test in inexpensive, takes only a few minutes, and can be done in a physician's office. An inexpensive blood test can also determine the presence of antibodies to the mononucleosis virus.

Treatment

Effective treatment varies depending on the cause of the sore throat. As frustrating as it may be to the patient, viral sore throat is best left to run its course without drug treatment. Antibiotics have no effect on a viral sore throat. They do not shorten the length of the illness, nor do they lessen the symptoms.

Sore throat caused by a streptococci or another bacteria must be treated with antibiotics. Penicillin is the preferred medication. Oral penicillin must be taken for 10 days. Patients need to take the entire amount of antibiotic prescribed, even after symptoms of the sore throat improve. Stopping the antibiotic early can lead to a return of the sore throat. Occasionally a single injection of long-acting penicillin G is given instead of 10 days of oral treatment. These medications generally cost under $15.

Because mononucleosis is caused by a virus, there is no specific drug treatment available. Rest, a healthy diet, plenty of fluids, limiting heavy exercise and competitive sports, and treatment of aches with acetaminophen (Datril, Tylenol, Panadol) or ibuprofen (Advil, Nuprin, Motrin, Medipren) will help the illness pass. Nearly 90% of mononucleosis infections are mild. The infected person does not normally get the disease again.

In the case of chronic sore throat, it is necessary to treat the underlying disease to heal the sore throat. If a sore throat caused by environmental factors, the aggravating stimulus should be eliminated from the sufferer's environment.

Home care for sore throat

Regardless of the cause of a sore throat, there are some home care steps that people can take to ease their discomfort. These include:

• taking acetaminophen or ibuprofen for pain; aspirin should not be given to children because of its association with increased risk for Reye's Syndrome, a serious disease
• gargling with warm double strength tea or warm salt water made by adding 1 tsp of salt to 8 oz (237 ml) of water
• drinking plenty of fluids, but avoiding acid juices like orange juice, which can irritate the throat (sucking on popsicles is a good way to get fluids into children)
• eating soft, nutritious foods like noodle soup and avoiding spicy foods
• refraining from smoking
• resting until the fever is gone, then resuming strenuous activities gradually
• a room humidifier may make sore throat sufferers more comfortable
• antiseptic lozenges and sprays may aggravate the sore throat rather than improve it

Alternative treatment

Alternative treatment focuses on easing the symptoms of sore throat using herbs and botanical medicines.

• Aromatherapists recommend inhaling the fragrances of essential oils of lavender (Lavandula officinalis), thyme (Thymus vulgaris ), eucalyptus (Eycalyptus globulus ), sage (Salvia officinalis ), and sandalwood.
• Ayurvedic practitioners suggest gargling with a mixture of water, salt, and tumeric (Curcuma longa ) powder or astringents such as alum, sumac, sage, and bayberry (Myrica spp.).
• Herbalists recommend taking osha root (Ligusticum porteri ) internally for infection or drinking ginger (Zingiber officinale ) or slippery elm (Ulmus fulva ) tea for pain.
• Homeopaths may treat sore throats with superdilute solutions Lachesis, Belladonna, Phytolacca ), yellow jasmine (Gelsemium ), or mercury.
• Nutritional recommendations include zinc lozenges every two hours along with vitamin C with bioflavonoids, vitamin A, and beta-carotene supplements.

Prognosis

Sore throat caused by a viral infection generally clears up on its own within one week with no complications. The exception is mononucleosis. Ninety percent of cases of mononucleosis clear up without medical intervention or complications, so long as dehydration does not occur. In young children the symptoms may last only a week, but in adolescents the symptoms last longer. Adults over age 30 have the most severe and long lasting symptoms. Adults may take up to six months to recover. In all age groups fatigue and weakness may continue for up to six weeks after other symptoms disappear.

In rare cases of mononucleosis, breathing may be obstructed because of swollen tonsils, adenoids, and lymph glands. If this happens, the patient should immediately seek emergency medical care.

Patients with bacterial sore throat begin feeling better about 24 hours after starting antibiotics. Untreated strep throat has the potential to cause scarlet fever, kidney damage, or rheumatic fever. Scarlet fever causes a rash, and can cause high fever and convulsions. Rheumatic fever causes inflammation of the heart and damage to the heart valves. Taking antibiotics within the first week of a strep infection will prevent these complications. People with strep throat remain contagious until after they have been taking antibiotics for 24 hours.

Prevention

There is no way to prevent a sore throat; however, the risk of getting one or passing one on to another person can be minimized by:

• washing hands well and frequently
• avoiding close contact with someone who has a sore throat
• not sharing food and eating utensils with anyone
• not smoking
• staying out of polluted air

Resources

BOOKS

Berktow, Robert, editor. The Merck Manual of Diagnosis and Therapy. 16th ed. Rahway, NJ: Merck Research Laboratories, 1992.

KEY TERMS

Antigen— A foreign protein to which the body reacts by making antibodies

Conjunctivitis— An inflammation of the membrane surrounding the eye; also known as pinkeye.

Lymphocyte— A type of white blood cell. Lymphocytes play an important role in fighting disease.

Pharynx— The pharynx is the part of the throat that lies between the mouth and the larynx or voice box.

Toxin— A poison. In the case of scarlet fever, the toxin is secreted as a byproduct of the growth of the streptococcus bacteria and causes a rash.

SORE THROAT

DEFINITION

Sore throat is a painful inflammation of the pharynx. The pharynx (pronounced FAAR-ingks) is the part of the throat that lies between the mouth and the larynx (pronounced LAAR-ingks), or voice box. It is associated most commonly with the common cold (see common cold entry) or influenza (the flu; see influenza entry). While most sore throats heal without complications, in some cases, they develop into a serious illness.

DESCRIPTION

Almost everyone gets a sore throat at one time or another. Children tend to have them more often than adolescents or adults. Sore throats are most common during the winter months. Infections of the upper respiratory (breathing) tract are more common then and these infections can cause a sore throat.

Sore throats can be either acute or chronic. An acute sore throat comes on suddenly and usually lasts three to seven days while a chronic sore throat lasts much longer.

CAUSES AND SYMPTOMS

Sore throats have many different causes. Proper treatment depends on understanding the cause of the sore throat.

Viral Sore Throat

Viruses cause 90 to 95 percent of all sore throats. Cold and flu viruses are usually responsible for the condition. These viruses cause an inflammation of the throat and sometimes the tonsils. Symptoms of a viral infection include a runny nose, cough, congestion, hoarseness, and fever. The level of pain varies considerably. It may be quite mild or very severe. In the worst cases, a patient may not be able to eat, breathe, swallow, or speak.

Another group of viruses that cause sore throat are the adenoviruses (pronounced AD-nn-oh-VY-russ-ez). The adenoviruses usually cause infections of the lungs and ears. In addition to those symptoms described above, adenoviruses may cause white bumps on the tonsils and throat, diarrhea, vomiting, and a rash. Sore throats caused by these viruses last about a week.

A third type of virus responsible for causing sore throat is the coxsackie virus. This virus causes a disease known as herpangina (pronounced hurpan-JI-nuh). Herpangina occurs most commonly among children under the age of ten. The disease is most common during the summer. It is sometimes called summer sore throat.

Summer sore throat can be quite severe. Symptoms include a high fever and the presence of tiny grayish-white blisters on the throat and mouth. These blisters break open and become very painful. People with this form of sore throat may vomit, have abdominal pain, and, generally, feel very sick.

A fourth type of virus that causes sore throat is the Epstein-Barr virus, (EHP-stine BAR) which also causes mononucleosis (see infectious mononucleosis entry). Mononucleosis is a very common disease. About 80 to 95 percent of all Americans have had the disease by age forty. Symptoms are mild and the disease usually clears up quickly. It can, however, produce a very painful sore throat.

There is no simple way to distinguish a viral sore throat from a bacterial sore throat. Viral sore throats are quite contagious. They can be spread by personal contact and by coughing or sneezing.

Bacterial Sore Throat

About 5 to 10 percent of all sore throats are caused by bacteria. The most common bacterial sore throat is caused by a bacterium called group A Streptococcus (pronounced strep-tuh-KOK-us). This type of sore throat is usually called strep throat (see strep throat entry). Bacterial sore throats can also be caused by the Gonococcus bacterium (pronounced GAHN-uh-KOCK-us). This bacterium also causes the sexually transmitted disease gonorrhea (see sexually transmitted diseases entry). Bacterial sore throats are also contagious.

Sore Throat: Words to Know

Adenoviruses:

A group of viruses that usually cause infections of the lungs and ears.

Antibiotic:

A substance derived from bacteria or other organisms that fights the growth of other bacteria or organisms. Useful in treating bacterial sore throats, antibiotics are not effective against viral sore throats.

Coxsackie virus:

A virus that causes a disease known as herpangina.

Gonorrhea:

A sexually transmitted disease caused by the Gonococcus bacterium.

Larynx:

The voice box.

Lymph nodes:

Small round or oval bodies within the immune system. Lymph nodes provide materials that fight disease and help remove bacteria and other foreign material from the body.

Mononucleosis:

A highly infectious disease caused by Epstein-Barr virus. Characterized by fever, swollen lymph nodes and sore throat.

Pharynx:

The part of the throat that lies between the mouth and the larynx, or voice box.

Noninfectious Sore Throat

Not all sore throats are caused by infection. For example, people with allergies often have sore throats. The sore throat is caused by fluids dripping from the back of the person's nose into the throat. These fluids irritate the pharynx.

Many materials in the environment can also irritate the pharynx. Such irritants include cigarette smoke, polluted air, chemical fumes, and dry air. These forms of sore throat are not contagious.

DIAGNOSIS

Sore throats are easy to diagnose from a patient's symptoms. However, the type of sore throat is usually difficult to diagnose. Most sore throats clear up quickly on their own, so a detailed diagnosis as to exact cause is usually not necessary. However, sore throats can sometimes continue for a relatively long time. In that case, medical advice should be sought. Some types of sore throat can develop into serious diseases.

Diagnosis of sore throat begins with a medical history and a physical examination. In the medical history, the doctor will try to find out if the patient has been near someone with a cold or the flu. If so, the patient may have contracted the sore throat by way of that contact.

COUGH DROPS

Coughing serves an important function in the human body. It provides a way of expelling (getting rid of) harmful materials that get into the body. But coughing is an annoying, and sometimes crippling, pattern.

Throughout history, humans have used all kinds of natural products to relieve coughing. Today, one of the most popular cough treatments is the cough drop. The cough drop is similar to liquid cough medicine, except that it is prepared in a more convenient form.

The first commercial cough drops were prepared by James Smith, of Poughkeepsie, New York, in the mid-1850s. Smith made his cough drops in a pot on his kitchen stove. He then began selling them as the James Smith and Sons Compound of Wild Cherry Cough Candy in 1852. He claimed that the product would relieve coughs, colds, hoarseness, and sore throat.

Later, Smith's sons joined their father in the business. When other companies also began to make cough drops, the Smiths decided they needed to make their product distinctive. They began to package their cough drops in boxes with pictures of the two sons on the front. They also protected the name of their product by putting the words "Trade Mark" on the package. The two words, "Trade" and "Mark," appeared below the pictures of the two sons. Very soon, people who bought cough drops began to think of the two boys as "Trade" and "Mark." Many never knew that their real names were William and Andrew.

The physical examination may provide further information. The doctor may discover a sinus infection, bronchitis, or some other infection of the upper respiratory tract. Any one of these infections could be the cause of the sore throat. If the doctor suspects strep throat, laboratory tests may be ordered. These tests will tell whether the Streptococcus bacterium is present or not.

A simple, quick, and inexpensive test is available for mononucleosis. If the doctor suspects that the patient has this disease, the test can be performed in the office.

TREATMENT

For the vast majority of sore throats, there are no treatments to cure the disease. These cases of sore throat are caused by viruses, against which there are few medications. Antibiotics may be prescribed for bacterial sore throats. But they will have no effect on viral sore throats.

The usual medication prescribed for bacterial sore throats is penicillin. Penicillin can be given either as a single injection or a series of pills. The pills must be taken for ten days. If a patient does not take the full course of pills the infection may return.

A number of treatments are available for the symptoms of sore throat. These include rest, a healthy diet, plenty of fluids, restrictions on heavy exercise, and a variety of drugs. The drugs that are usually recommended are aspirin, acetaminophen (trade name Tylenol), or ibuprofen (trade names Advil, Motrin). These medications reduce pain and fever that accompany a sore throat.

Chronic sore throat requires a somewhat different treatment. In many cases, the sore throat is not caused by an infection. Instead, it may be produced by some environmental condition. People who work around chemicals, for example, may have chronic sore throats. In such cases, it may be necessary to change the patient's working conditions in order to provide relief for the sore throat.

Home Care for Sore Throat

Sore throat is usually not a very serious disease. It can be treated most effectively with some simple remedies available in the home, including:

• Taking aspirin, acetaminophen, or ibuprofen for pain. But children should not be given aspirin because of the risk of Reye's syndrome (see Reye's syndrome entry).
• Gargling with warm tea or warm salt water
• Drinking plenty of fluids but avoiding fruit juices
• Eating soft, nutritious foods, such as noodle soup, and avoiding spicy foods
• Refraining from smoking
• Resting until the fever is gone
• Increasing the humidity of a room with a room humidifier
• Avoiding the use of antiseptic lozenges and sprays, which are likely to make the condition more uncomfortable

Alternative Treatment

Alternative practitioners recommend a variety of natural products for the treatment of sore throat. For example, aromatherapists recommend inhaling the fragrances of lavender, thyme, eucalyptus, sage, and sandalwood. Herbalists recommend taking osha root, ginger, or slippery elm. Some practitioners suggest gargling with a mixture of water, salt, and tumeric. Homeopathic practitioners treat sore throats with very dilute solutions of Lachesis, Belladonna, Phytolacca, yellow jasmine, or mercury. Nutritionists recommend vitamins and minerals such as vitamins A or C and the mineral zinc.

PROGNOSIS

Sore throat caused by a viral infection usually clears up on its own within one week with no complications. The one exception is mononucleosis. Most cases of mononucleosis also clear up on their own but the recovery period may be much longer. Among adults, it may take up to six months to recover completely from mononucleosis. In rare cases, mononucleosis may lead to complications, such as swollen tonsils, adenoids, and lymph nodes. Lymph nodes are small round or oval bodies that are part of the body's immune system. If this happens, the patient should seek emergency medical care.

Patients with bacterial sore throat usually begin to feel better about 24 hours after starting on antibiotics. An antibiotic is a substance derived from bacteria or other organisms that fights the growth of other bacteria or organisms. Strep throat is the most serious form of sore throat since it can lead to serious complications. These complications include scarlet fever (see scarlet fever entry), kidney damage, and rheumatic fever. Treatment with antibiotics during the early stages of sore throat can usually avoid these complications.

PREVENTION

It is difficult to avoid getting a sore throat. People carrying the viruses and bacteria that cause the disease are all around us. The chance of being infected can be reduced, however. Some simple rules to follow include the following:

• Wash hands frequently and well.
• Avoid close contact with someone who has a sore throat.
• Do not share food and eating utensils with anyone.
• Do not smoke.
• Stay out of polluted air.

FOR MORE INFORMATION

Web sites

"Ask NOAH About: Pain." NOAH: New York Online Access to Health. [Online] http://www.noah.cuny.edu/pain/pain.html#S (accessed on October 31, 1999).

National Institute of Allergy and Infectious Diseases. "Infectious Mononucleosis Fact Sheet." [Online] http://www.niaid.nih.gov/factsheets/infmono.htm (accessed September 1, 1997).

Sore Throat

What Is a Sore Throat?

Are Sore Throats Common?

What Are the Signs and Symptoms of a Sore Throat?

How Do Doctors Diagnose the Cause of a Sore Throat?

How Is a Sore Throat Treated?

Can Sore Throats Be Prevented?

Resources

The pain and discomfort of a sore throat, also called pharyngitis (fair-un-JY-tis), are usually the result of inflammation due to infection or irritation.

KEYWORDS

for searching the Internet and other reference sources

Adenovirus

Common cold

Group A streptococci

Influenza

Mononucleosis

Pharyngitis

Strep throat

Streptococcal Infections

Viral Infections

What Is a Sore Throat?

A sore throat can be a symptom of many infectious diseases. Viral infections such as the common cold, influenza*, adenovirus* infection, and infectious mononucleosis* cause most sore throats. Bacterial infections are less common, but the sore throats they produce usually are more severe. Group A beta hemolytic streptococci (he-muh-LIH-tik strep-tuh-KAH-kye) are the most common bacterial culprits, and they cause strep throat. Rarely, fungal infections can cause a sore throat, usually in people with weakened immune systems. Non-infectious causes of sore throat include allergies, postnasal drip (the dripping of mucus from the back of the nose into the throat), and too much yelling or straining the voice. Smoking and other irritants also can cause a sore throat.

*influenza

(in-floo-EN-zuh), also known as the flu, is a contagious viral infection that attacks the respiratory tract.

*adenovirus

(ah-deh-no-VY-rus) is a type of virus that can produce a variety of symptoms, including upper respiratory disease, when it infects humans.

*mononucleosis

(mah-no-nu-klee-O-sis) is an infectious illness caused by a virus with symptoms that typically include fever, sore throat, swollen glands, and tiredness.

Are Sore Throats Common?

Sore throats are very common, especially in children. It is not unusual for children between the ages of 5 and 10 to develop several sore throat infections over the course of a year. Most of these illnesses are common viral respiratory infections. About 15 percent of all sore throats are caused by group A streptococci.

All of the infections that cause sore throats are contagious. They can spread through contact with drops of fluid from an infected person that can be coughed or sneezed into the air. The drops can be inhaled or transferred by the hand to the mouth or nose. The infections that cause sore throats also can spread through direct contact with an infected person, such as through kissing.

What Are the Signs and Symptoms of a Sore Throat?

Sore throats are painful, sometimes swollen, and red. Many viral infections that cause sore throats are associated with other symptoms, including hoarseness, runny nose, cough, and diarrhea (dye-uh-REE-uh).

Streptococcal infections frequently produce a bright red throat, trouble swallowing, and swollen, often tender lymph nodes* in the neck. The tonsils* often are enlarged, there may be white specks and pus* on them, or they may be covered with a gray or white coating. Other symptoms of strep throat include high fever, headache, and abdominal* pain.

*lymph

(LIMF) nodes are small, bean-shaped masses of tissue that contain immune system cells that fight harmful microorganisms. Lymph nodes may swell during infections.

*tonsils

are paired clusters of lymph tissue in the throat that help protect the body from bacteria and viruses that enter through a person’s nose or mouth.

*pus

is a thick, creamy fluid, usually yellow or greenish in color, that forms at the site of an infection. Pus contains infection-fighting white cells and other substances.

*abdominal

(ab-DAH-mih-nul) refers to the area of the body below the ribs and above the hips that contains the stomach, intestines, and other organs.

Sore throat is a common symptom of infectious mononucleosis, a viral infection caused by the Epstein-Barr (EP-steen BAR) virus. The tonsils become very swollen and, as in strep throat, may have white patches or an extensive coating. Swallowing is difficult and, in a few cases, the tonsils enlarge enough to cause difficulty breathing. Other signs and symptoms of mononucleosis include swollen lymph nodes in the neck, fever, extreme tiredness, muscle aches, and an enlarged spleen.

How Do Doctors Diagnose the Cause of a Sore Throat?

If the doctor suspects that a patient might have a strep throat infection, the doctor will use a cotton swab to take a sample from the throat and tonsils for a culture*. Often, the doctor will do a rapid strep test in the office, but this quick test is not as reliable as a culture.

*culture

(KUL-chur) is a test in which a sample of fluid or tissue from the body is placed in a dish containing material that supports the growth of certain organisms. Typically, within days the organisms will grow and can be identified.

Infectious mononucleosis is diagnosed by examining blood samples for antibodies* to the virus. Nasal and throat swabs can be tested to detect other causes of a sore throat, if necessary. If a patient’s sore throat and other symptoms match those of a common viral cold or respiratory infection, the doctor may base the diagnosis on the physical symptoms alone.

*antibodies

(AN-tih-bah-deez) are protein molecules produced by the body’s immune system to help fight specific infections caused by microorganisms, such as bacteria and viruses.

How Is a Sore Throat Treated?

Treatment of a sore throat depends on the diagnosis. If it stems from a common cold caused by a virus, treatment is aimed at relieving symptoms until the illness disappears. Drinking plenty of fluids can help prevent dehydration* and clear out mucus* in the back of the throat. Water, ginger ale, warm tea with honey, and soups are good choices, but not acidic juices (such as lemonade or orange juice), because they can irritate the throat. Gargling with warm salt water can help soothe a sore throat, and over-the-counter pain relievers and throat drops can help ease symptoms as well. Antibiotics are not effective for treating viral infections such as colds. Most viral sore throats go away on their own without complications, and they generally clear up within a few days to a week.

*dehydration

(dee-hi-DRAY-shun) is a condition in which the body is depleted of water, usually caused by excessive and unre-placed loss of body fluids, such as through sweating, vomiting, or diarrhea.

*mucus

(MYOO-kus) is a thick, slippery substance that lines the insides of many body parts.

When strep throat has been diagnosed, a 10-day course of antibiotics usually is prescribed; all of the antibiotics should be taken as directed to prevent complications. Strep throat can lead to rheumatic fever*, kidney* problems, or throat abscesses*, and prompt treatment with antibiotics can prevent some of these complications. Symptoms of strep throat usually improve within 1 to 2 days of starting antibiotics.

*rheumatic

(roo-MAH-tik) fever is a condition associated with fever, joint pain, and inflammation affecting many parts of the body, including the heart. It occurs following infections with certain types of strep bacteria.

*kidney

is one of the pair of organs that filter blood and remove waste products and excess water from the body in the form of urine

*abscesses

(AB-seh-sez) are localized or walled off accumulations of pus caused by infection that can occur in the skin and anywhere within the body.

The best treatment for infectious mononucleosis is rest. In addition, over-the-counter medications such as acetaminophen (uh-see-teh-MIH-noh-fen) can help relieve pain and fever. Infectious mononucleosis can take from 1 to 2 months to subside, and other symptoms from the illness, such as tiredness, can remain for months after.

Can Sore Throats Be Prevented?

Many respiratory infections are spread through contact with respiratory fluids from infected people. The best prevention strategy is basic hygiene, which includes covering the mouth when sneezing or coughing and washing hands regularly. If someone has an infection or has been in close contact with someone who does, it is wise not to share utensils, food, and drinking glasses with that person.

See also

Common Cold

Influenza

Laryngitis

Mononucleosis, Infectious

Sinusitis

Streptococcal Infections

Resources

Organizations

National Institute of Allergy and Infectious Diseases (NIAID), Building 31, Room 7A-50, 31 Center Drive MSC 2520, Bethesda, MD 20892. The NIAID, part of the National Institutes of Health, posts information about sore throats at its website.

http://www.niaid.nih.gov

U.S. National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894. The National Library of Medicine has a website packed with information on diseases and conditions such as sore throat. It also offers consumer resources, dictionaries and encyclopedias of medical terms, and directories of doctors and helpful organizations.

Telephone 888-346-3656 http://www.nlm.nih.gov

Website

KidsHealth.org. KidsHealth is a website created by the medical experts of the Nemours Foundation and is devoted to issues of children’s health. It contains articles on a variety of health topics, including sore throat.

http://www.KidsHealth.org

sore throat n. pain at the back of the mouth, commonly due to tonsillitis or pharyngitis. If infection persists the lymph nodes in the neck may become tender and enlarged (cervical adenitis).