Sore Throat



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.


  • 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


  • Infectious
    • Urgent/emergent: epiglottitis, peritonsillar cellulitis/abscess, retropharyngeal abscess, Lemierre syndrome
    • Viral: adenovirus, influenza, coxsackie, 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, 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 or aerosolized irritant
  • Trauma
    • Foreign body: either retained or causing laceration to posterior pharynx
    • Burns: hot liquids/foods
    • Caustic ingestion
    • Voice overuse
  • Tumor
    • Acute lymphocytic leukemia (ALL) or T-cell lymphoma can rarely present as sore throat and fever.
  • Miscellaneous
    • Kawasaki disease
    • PFAPA: periodic fever, aphthous stomatitis, pharyngitis, adenitis
    • Psychogenic pain
    • Referred pain

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