Sore Throat

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Definition of a sore throat

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A sore throat is a discomfort or pain in the throat area, which is typically worsened by swallowing. The underlying cause of a sore throat is most frequently due to an infectious inflammatory process of the pharynx, tonsils, or larynx (hence the terms pharyngitis, tonsillitis and laryngitis). Though this particular symptom can be present in many different medical conditions, it is most often experienced during an upper respiratory infection (a "cold"). Viruses cause the vast majority of cases of sore throat, and individuals generally improve with expectant management and symptomatic treatment. In certain cases, however, sore throat can be caused by infectious agents (such as bacteria) that require a different treatment approach.

What is the difference between sore throat and strep throat?

Sore throat is a generic term used to describe the symptom of discomfort and pain in the throat area. It does not specify the underlying cause.

Strep throat is a bacterial infection of the throat and tonsils that causes a sore throat. It is important to note that not all cases of sore throat are necessarily strep throat. Strep throat is specifically caused by group A Streptococcus bacteria, and there are characteristic signs and symptoms, as well as laboratory testing, that can assist in making this particular diagnosis.

What are the causes of sore throat?

There are several different causes of sore throat, which may include the following:

  • Viral infection: This is by far the most common cause of a sore throat, and there are several different viruses that can lead to the common cold and an upper respiratory infection. Certain viruses such as the influenza virus (influenza, flu), Epstein-Barr virus (mononucleosis), mumps virus (mumps), parainfluenza virus (croup) and Coxsackie A virus (herpangina) also cause sore throat.
  • Bacterial infection: A less common cause of sore throat, a bacterial infection can lead to strep throat, peritonsillar abscess, retropharyngeal abscess, diphtheria, epiglottitis, and tonsillitis. Certain sexually transmitted diseases (STD's), such as gonorrhea and chlamydia, also can rarely cause a sore throat.
  • Toxins/Irritants: Various substances such a cigarette smoke, air pollution, and noxious airborne chemicals can lead to a sore throat. Medical conditions such as postnasal drip, allergies, cough, gastroesophageal reflux disease (GERD), and tumors can cause a sore throat. The intentional or unintentional ingestion of certain substances (for example, bleach) can cause a sore throat.
  • Trauma/Injury: Any direct injury to the throat or neck area can lead to a sore throat. Sometimes, a foreign body (for example, a bone or piece of food) can cause a sore throat. Excessive yelling or screaming can irritate the throat and larynx, also leading to a sore throat.
Medically Reviewed by a Doctor on 10/18/2013

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Sore Throat: Virus or Strep?

Medical Author: Melissa Stöppler, M.D.
Medical Editor: William C. Shiel, Jr, MD, FACP, FACR

Are you wondering if your sore throat requires antibiotics? Strep throat, named for the Streptococcus bacterium that causes the condition, is a particularly severe form of sore throat that is best treated with antibiotics. Strep throat can strike both children and adults, but only about five to ten percent of sore throats are caused by a bacterial infection. Most sore throats are caused by viral illnesses and are not responsive to treatment with antibiotics.

A true streptococcal infection of the throat often leads to excruciating throat pain accompanied by difficulty swallowing and even speaking. Fever may be present, and the tonsils are often covered with a whitish layer of pus. Cough and runny nose are not commonly related to strep throat, but it is possible to have a streptococcal infection along with a viral upper respiratory infection and symptoms of a cold. The bacterial infection may result in enlarged, tender lymph nodes in the neck. Children may have an accompanying rash; a streptococcus infection along with a rash is commonly termed scarlet fever.

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