Sore Throat (Pharyngitis) – Causes, Symptoms, Treatment, Medications

A sore throat, or acute pharyngitis, is one of the most common winter complaints. It is a symptom of infection, usually viral, or of an irritation of the pharynx – the back portion of the mouth behind the tongue.

The irritation may be a local throat infection or the result of post-nasal drip caused by discharge from allergies, sinusitis, or a head cold.

Pharyngitis can result in very large tonsils which cause trouble swallowing and breathing. Pharyngitis can be accompanied by a cough or fever, caused by a systemic infection.


Almost everyone is susceptible to pharyngitis at one time or another. Frequent episodes can be the sign of underlying disorders or chronic disease such as diabetes, malnutrition, or immune disorders.

A sore throat can have many causes including:

  • Common viruses, including the viruses that cause mononucleosis (mono) and the flu. Some viruses can also produce blisters in the mouth and throat (“aphthous stomatitis”).
  • Breathing through the mouth or smoking can produce throat dryness and soreness.
  • Sinus drainage (post nasal drip)
  • Bacterial infections. The two most common bacteria to cause a sore throat are Streptococcus (which causes strep throat) and Arcanobacterium haemolyticum. Arcanobacterium causes sore throats mainly in young adults and is sometimes associated with a fine red rash.
  • Sore throat appearing after treatment with antibiotics, chemotherapy, or other immune compromising medications may be due to the yeast Candida, a condition commonly known as “thrush.”
  • A sore throat lasting for more than two weeks can be a sign of a serious illness, such as throat cancer or AIDS.

Symptoms Pharyngitis:

Viral pharyngitis may develop gradually. It is often accompanied by the flu or a cold, and body aches. If a fever is present, it will generally be in the range of 101 degrees F or below. A bacterial sore throat may be associated with swollen and tender lymph nodes in the neck. Fever is typically 102 degrees F or higher. The throat may appear extremely red and have either white or yellow spots at the back.

Other symptoms that may accompany a sore throat include:

  • Coughing
  • Sneezing
  • Hoarseness or laryngitis
  • Runny nose
  • Mild fever
  • General fatigue
  • Swollen lymph nodes
  • Bad breath


An abscess has formed in the throat and pus is collecting beyond the wall of the tonsils. Both the tongue and throat may swell. Other symptoms include a fever of 103 degrees F, with swollen, tender glands in the neck, and difficulty swallowing. A tonsillectomy may be recommended for a child who has: three or more strep throats per year more than five non-strep sore throats per year that require doctor visits enlarged tonsils that interfere with nighttime  breathing.


  • Analgesics such as NSAIDs and acetaminophen can help reduce the pain associated with a sore throat. Steroids (such as dexamethasone) have been found to be useful for severe pharyngitis.
  • Viscous lidocaine relieves pain by numbing the mucus membranes. Antibiotics are useful if group a streptococcus is the cause of the sore throat. For viral infections, antibiotics have no effect.