During this time of year it is very common for patients to get a sore throat for a variety of reasons. It is one of the most common reasons that patients come to see. The primary concern most patients have in regards to a sore throat is whether they have strep throat or not.
So does sore throat mean strep throat?
The answer is no. We all know that strep throat is very common in children. It can be the cause of a sore throat in up to 40 % of cases in children. However, what is not often known is how often strep throat is the cause of sore throat in adults.
Interestingly, strep throat only accounts for about 5 to 15 percent of cases of sore throat in adults presenting with sore throat.
So what are the common causes of sore throat?
Group A streptococcus (Strep throat) — The clinical features of strep throat include sore throat, pus on the tonsils, swelling of glands in the neck, and fever. I find that in adults cough and runny nose are typically absent. In young children the symptoms can be a little less textbook and there sometimes can be cough and congestion.
Viruses — The most common causes of sore throat are viral agents. Patients with a virus often also have cough, body aches, and swollen/red tonsils. Pus on the tonsils is uncommon even in the presence of severe sore throat pain.
Epstein Barr Virus (Mono) — Infectious mononucleosis is best known as "Mono". Mono often begins with feeling sick, headache, and low-grade fever before development of the more specific signs of sore throat/tonsillitis, swollen glands, and moderate to high fever. Fatigue is a prominent component when sore throat is due to Mono.
There are many other viruses associated with sore throat in adults. These include the flu virus, the cold viruses, RSV, the croup virus, and HIV.
Other bacteria - There are also other types of bacterial infection that cause sore throat besides the classic group A Streptococcus. These include other types of strep or more rare bacteria like diptheria.
Non-infectious causes — The most common non-infectious cause of sore throat is allergies. Other causes include environmental exposures and acid reflux. Dry air is also a common cause.
What are some dangerous conditions and symptoms associated with sore throat?
Some dangerous conditions associated with sore throat include when patients have unusually severe signs and symptoms such as inability to swallow, a muffled "hot potato" voice, or neck swelling. The conditions should be evaluated immediately for possible abscess, swelling of the epiglottitis, or neck infections.
How do we detect strep throat?
Most of us are familiar with the strep test. The strep test will pick up strep throat in about 70 - 90 % of cases. The definitive test is a throat culture.
When should you seek medical attention?
The good news is that strep throat is very treatable and most viruses resolve on their own without treatment. If your sore throat symptoms are similar to the classical criteria for strep then seek immediate medical attention. In additon, you should seek medical attention if your sore throat is severe, worsens, or doesn't improve after five to seven days of symptomatic treatment.
For those with questions about a sore throat or need to be evaluated I am happy to help. Feel free to reach out or visit the contact page for more information.
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