Sore Throat (Pharyngitis and Tonsillitis)

A sore throat is pain, scratchiness or irritation of the throat that is usually worse on swallowing. The medical terms are pharyngitis when the back of the throat is inflamed and tonsillitis when the tonsils are mainly involved. Most are caused by viruses and clear in about a week.

Antibiotics help only the minority caused by bacteria, mainly group A streptococcus. A sore throat lasting more than 3 weeks is a different matter and needs examination to look for reflux, chronic tonsil problems or, particularly in smokers, a growth.

Symptome

• Pain on swallowing, sometimes shooting to the ears
• Red throat, swollen tonsils, sometimes with white spots
• Tender swollen glands in the neck
• Fever, headache and aching
• Cough, runny nose and hoarse voice, which point towards a virus
• Bad breath and small white tonsil stones in chronic tonsillitis
• Morning throat irritation and throat clearing in reflux

Ursachen und Risikofaktoren

Viruses cause roughly seven in ten sore throats in adults, including common cold viruses, influenza, COVID-19 and Epstein-Barr virus, which causes glandular fever in teenagers and young adults. Group A streptococcus accounts for most bacterial cases and is more frequent in school-age children. Non-infectious causes include acid reflux reaching the throat, mouth breathing from a blocked nose, smoking, dry air, voice strain, postnasal drip and allergy. Persistent one-sided pain can come from a tonsil or tongue base tumour, some of which are linked to HPV.

Wie es diagnostiziert wird

• Throat and neck examination: The appearance of the tonsils, glands and the presence or absence of cough feed into a clinical score that estimates the chance of streptococcal infection.
• Rapid strep test or throat swab: A swab gives a result in minutes or, for culture, in 1 to 2 days, and guides the decision on antibiotics.
• Blood tests: Blood count and a glandular fever test when illness is prolonged with marked tiredness and gland swelling.
• Flexible nasendoscopy: A camera examination of the throat and voice box for sore throats lasting beyond 3 weeks.
• Imaging and biopsy: Ultrasound or CT for a suspected abscess or neck lump, and biopsy of any suspicious area.

Behandlungsmöglichkeiten

• Self-care: Fluids, paracetamol or ibuprofen, salt-water gargles, lozenges or anaesthetic sprays, and rest. Most cases need nothing more.
• Antibiotics: Penicillin for 10 days, or an alternative if allergic, for confirmed or highly likely streptococcal infection. Amoxicillin is avoided if glandular fever is possible because it causes a rash.
• Treatment of reflux and nasal causes: Dietary changes and acid suppression for reflux, and treatment of nasal blockage or allergy that forces mouth breathing.
• Drainage of a peritonsillar abscess: Needle or small incision under local anaesthetic, with antibiotics. Relief is rapid.
• Tonsillectomy: For frequent documented tonsillitis, repeated abscess, or obstructive tonsils. Adult recovery takes about 2 weeks and is painful.

Wenn es dringend ist

Seek emergency care locally if you cannot swallow your saliva and are drooling, have difficulty breathing or noisy breathing, cannot open your mouth fully, have a muffled voice with severe one-sided pain, a stiff or swollen neck, or a high fever with a widespread rash. These can signal a quinsy, epiglottitis or a deep neck infection.

Reisen nach Türkiye zur Behandlung

An acute sore throat will be over before you could travel, and should be managed locally. Two situations can justify a visit: a persistent sore throat needing endoscopy and a clear diagnosis, and planned tonsillectomy for recurrent tonsillitis. For tonsillectomy, plan to stay 10 to 14 days, because bleeding can occur in the second week and flying during that period is unwise.

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