Sore Throat

Descriptive text is not available for this imageBASICS

DESCRIPTION

Throat pain with swallowing (odynophagia) or without swallowing may be a lone complaint or accompanied by a variety of other complaints. The most likely etiologies are self-limited but must rule out potentially life-threatening causes.

EPIDEMIOLOGY

  • Sore throat is a common complaint year-round, but etiology depends on season and age of patient.
  • In winter months, viral agents are more active.
  • In spring and fall, postnasal drip from allergic rhinitis is a common cause of throat irritation.

GENERAL PREVENTION

  • Careful hand washing and avoidance of respiratory secretions are keys to minimizing spread of most infectious agents.
  • Noninfectious etiology often triggered by specific exposure, so avoidance of that trigger would limit symptoms

ETIOLOGY

  • Infectious
    • Urgent/emergent
      • Epiglottitis
      • Peritonsillar cellulitis/abscess
      • Retropharyngeal abscess
      • Lemierre syndrome
    • Viral
      • Adenovirus
      • Coronavirus (including SARS-CoV-2)
      • Influenza
      • Coxsackievirus
      • Parainfluenza
      • Epstein-Barr virus (EBV)
      • Cytomegalovirus (CMV)
      • Herpes simplex virus (HSV)
      • Human immunodeficiency virus
    • Bacterial:
      • Group A β-hemolytic Streptococcus (GAS)
      • Streptococcus pyogenes
      • Mycoplasma pneumoniae
      • Groups C and G streptococci
      • Diphtheria (Corynebacterium diphtheria)
      • Neisseria gonorrhoeae
      • Anaerobic bacteria
      • Tularemia
      • Arcanobacterium haemolyticum
    • Fungal: Candida
  • Allergic/inflammatory
  • Postnasal drip from allergic rhinitis
  • Gastroesophageal reflux disorder (GERD)
  • Eosinophilic esophagitis
  • Environmental
    • Tobacco smoke
    • Aerosolized irritant
  • Trauma
    • Foreign body: either retained or causing laceration to posterior pharynx
    • Burns: hot liquids/foods
    • Caustic ingestion
    • Voice overuse
  • Tumor
  • Kawasaki disease
  • PFAPA (periodic fever, aphthous stomatitis, pharyngitis, adenitis)
  • Psychogenic pain
  • Referred pain
  • Acute lymphocytic leukemia (ALL) or T-cell lymphoma can rarely present as sore throat and fever.

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