Sore throat, known as pharyngitis or tonsillitis (inflammation of the pharynx or tonsils, respectively), is one of the most common health complaints. The April 7, 2004, issue of JAMA includes an article about diagnosing and treating sore throats.
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Most sore throats are caused by infections with viruses, small organisms that do not respond to antibiotics. Examples include the sore throat of a common cold, influenza (flu), or infectious mononucleosis (a viral disease with sore throat, fever, and lymph node enlargement).
Other causes include
Bacterial infections, including strep throat, caused by Streptococcus bacteria
Coughing or yelling excessively
Low humidity
Smoking or air pollution
Allergies
Physical examination of the throat
A swab of the back of the throat may be taken for laboratory testing to determine if the sore throat is caused by a bacterial infection: a rapid test for strep or a throat culture, which is more accurate but takes several days for a result.
If the cause of your sore throat is a virus, your doctor will likely recommend that you drink plenty of fluids, get plenty of rest, and take an over-the-counter pain reliever if needed. Antibiotics will not help and will not shorten the duration of a sore throat caused by a virus.
Cough drops and gargling with warm water can help soothe a sore throat.
Antibiotics are prescribed if laboratory tests confirm that the sore throat is caused by bacteria, such as Streptococcus.
Using antibiotics when they are not needed can cause adverse effects in the person taking them and antibiotic resistance. Antibiotic resistance has become more common in recent years as a result of the overuse of antibiotics. Antibiotic-resistant bacteria must be treated with different, more powerful antibiotics and are much more difficult to treat.
If antibiotics are prescribed, it is important to take the entire course of medication exactly as prescribed. Stopping before your medication is finished because symptoms have cleared up can encourage antibiotic resistance—always take the full course.
Sore throats caused by viruses get better by themselves, usually within a week, without complications.
If strep throat goes untreated for too long, it may lead to an abscess in the throat, rheumatic fever, which can cause heart damage, or glomerulonephritis, which causes kidney damage. These complications are now uncommon in developed countries.
American Academy of Pediatrics 847/434-4000http://www.aap.org
National Institute of Allergy and Infectious Diseaseshttp://www.niaid.nih.gov
To find this and other JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. A Patient Page on coughs, colds, and antibiotics was published in the May 28, 2003, issue; and one on strep throat was published in the December 13, 2000, issue.
Sources: Centers for Disease Control and Prevention, National Institute of Allergy and Infectious Diseases
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.
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The Rational Clinical Examination Make the Diagnosis: Streptococcal Pharyngitis
The Rational Clinical Examination Original Article: Does This Patient Have Strep Throat?
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