Pharyngitis

Many germs can cause pharyngitis.

• Viruses are the most common cause of pharyngitis. Many different viruses can cause pharyngitis.
• Bacteria that can cause pharyngitis include Group A streptococcus, which leads to strep throatstrep throat in some cases. Other, less-common bacteria that cause sore throats include corynebacterium, arcanobacterium, Neisseria gonorrhoeae, and Chlamydia pneumoniae.

Most cases of pharyngitis occur during the colder months. The illness often spreads among family members.

The main symptom is a sore throatsore throat.

Other symptoms may include:

• FeverFever
• Headache
• Joint pain and muscle aches
• Skin rashes
• Swollen lymph nodesSwollen lymph nodes in the neck

Your health care provider will perform a physical exam and look at your throat.

A rapid test or throat culture to rule out strep throat may be done. Additional laboratory tests may be done depending on the suspected cause.

It is important to avoid antibiotics when a sore throat is due to infection with a virus. The antibiotics will not help. Using them to treat viral infections helps strengthen bacteria to become resistant to antibiotics.

Most sore throats are soon over. In the meantime, the following remedies may help:

• Drink warm liquids. Honey or lemon tea is a time-tested remedy.
• Gargle several times a day with warm salt water (1/2 tsp of salt in 1 cup water).
• Drink cold liquids or suck on popsicles.
• Suck on hard candies or throat lozenges to soothe your sore throat. This is often as effective as more expensive remedies. DO NOT use candies or lozenges in young children because of the choking risk.
• Use a cool-mist vaporizer or humidifier to moisten and soothe a dry and painful throat.
• Try over-the-counter pain medications, such as acetaminophen. DO NOT give aspirin to children.

Most cases of pharyngitis go away on their own without complications.

Complications of pharyngitis may include:

• Blockage of the airway (in severe cases)
• Sore (abscess) around the tonsils or behind the pharynx

Call your health care provider if:

• You develop a sore throat that does not go away after several days
• You have a high fever, swollen lymph nodes in your neck, or a rash

Seek immediate medical care if you have a sore throat and trouble breathing.

Pharyngitis - bacterial

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Jenson HB. Epstein-Barr virus. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 251.

Del Mar CB, Glasziou PP, Spinks A. Antibiotics for sore throat. Cochrane Database Syst Rev. 2008:(3):CD000023.

Institute for Clinical Systems Improvement. Health careguideline:Diagnosis and treatment of respiratory illness in children and adultsDiagnosis and treatment of respiratory illness in children and adults. Jan 2008. Accessed Jan 12, 2010.

Altamimi S, Khalil A, Khalaiwi KA, Milner R, Pusic MV, Al Othman MA. Short versus standard duration antibiotic therapy for acute streptococcal pharyngitis in children. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD004872.

Updated by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.