Sore Throat

A sore throat is a very common condition that can affect any individual at any stage of life. It is characterized by pain, irritation, or itchiness of the throat that can lead to difficulty in swallowing and speaking. It is usually a self-remitting condition but may occasionally require a visit to the doctor in some scenarios.

A sore throat is usually due to infection of the throat either by most commonly viruses but also occasionally bacteria. The infection is spread by direct contact to the saliva of an infected patient or by the air droplets exhaled by an infected patient. Transmission is usually higher in small, enclosed areas and in individuals who share eating utensils or drinking glasses. Transmission in children can be higher because of their hand-to-mouth habits and their sharing of toys.

Viral vs. Bacterial Sore Throat

There are no consistent signs that predict a viral vs. a bacterial infection however:

A viral sore throat is usually characterized by the following:

  • Runny nose
  • Cough
  • Hoarse voice
  • Itchy or red eyes
  • Itchy or painful throat

In contrast, more severe infections, which may or may not represent bacterial infections, are characterized by the following:

  • Severe pain in the throat
  • High-grade fever (higher than 38C)
  • Enlarged neck lymph nodes
  • White patches or pus on the tonsils

Among the various causes of sore throat, the Streptococcal bacteria is of particular importance because of its potential to cause long-lasting and even life-threatening complications. Thus, it is important to be able to identify if the etiologic agent of the sore throat is Streptococcus. Although the signs and symptoms of viral and bacterial sore throat overlap, most streptococcal infections are NOT usually associated with a runny nose, itchy eyes, or cough.

Other possible causes of a sore throat include:

  • Allergies
  • Dry air
  • Irritants, such as smoke or chemicals
  • Gastroesophageal reflux disease (GERD)

Home remedies

The main problem with sore throat is the difficulty in swallowing. Sucking on cough drops, popsicles, or candies can relieve this symptom. Gargling with salt water is also helpful in soothing the pain. If it is difficult to feed, foods with softer consistency (like soup or gelatin) and warm or cold drinks are encouraged, especially in children who can easily get dehydrated from refusal to feed.

Over-the-counter pain medications like acetaminophen and ibuprofen are also available. However, for children, the dosage of these medications is dependent on weight, so a doctor’s advice might be beneficial. Aspirin, a common pain medication, should not be given to children because it can cause Reye’s syndrome. Reye’s syndrome is a rare but potentially fatal condition that is characterized by rashes, seizures and confusion due to the swelling of the brain and the liver.

When to see a doctor

Although most sore throats resolve spontaneously, a visit to the doctor might be warranted in some cases. These include:

  • Any suspicion of streptococcal sore throat, such as symptoms of severe throat pain, high-grade fever, enlarged neck nodes and tonsillar patches
  • Severe throat pain that is not improving within 5 to 7 days
  • Hoarseness that lasts greater than 2 weeks
  • Difficulty in breathing
  • Difficulty in swallowing leading to drooling of saliva
  • Difficulty in moving the neck
  • Swelling of the neck
  • Difficulty in feeding especially in children
  • Any associated symptoms such as ear ache, rash, joint pain or blood in phlegm or saliva

A sore throat usually resolves spontaneously without the need for antibiotics; however, in some cases of bacterial sore throat, a doctor might prescribe antibiotics to prevent the development of complications, especially in the case of a Streptococcal infection. In addition, antibiotics can shorten the symptomatic period of sore throats and prevent the spread of infection to other people.


Work and other activities can be resumed as soon as an individual feels better. If antibiotics have to be taken, it is recommended that it should be taken for at least one day before going back to work or to school to prevent the spread of infection. If fever develops, resumption of work or other activities can be done 24 hours after the last episode of fever.


Sore throat is an infection that can spread by direct contact or by air droplets. One should cover their mouth when coughing or sneezing. Transmission can easily be prevented by frequent handwashing with soap and water. In children, especially in toddlers, teaching them to avoid putting their hands into their mouths, avoid sharing of utensils and glasses and avoid close contact with anyone who is sick can protect them from spreading and/or getting the infection. In addition, one should keep common surfaces clean, such as countertops, remote controls, and doorknobs.