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.
- 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
- 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
- Postnasal drip from allergic rhinitis
- Gastroesophageal reflux disorder (GERD)
- Eosinophilic esophagitis
- Tobacco smoke or aerosolized irritant
- Foreign body: either retained or causing laceration to posterior pharynx
- Burns: hot liquids/foods
- Caustic ingestion
- Voice overuse
- Acute lymphocytic leukemia (ALL) or T-cell lymphoma can rarely present as sore throat and fever.
- Kawasaki disease
- PFAPA: periodic fever, aphthous stomatitis, pharyngitis, adenitis
- Psychogenic pain
- Referred pain
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