Practice diagnosing and treating sore throats

2021-04-16 04:39 PM

Based on the timing of the symptoms. Most sore throats due to acute streptococcal and viral infection will subside within 5 to 7 days.

Sore throat is a dry, burning sensation in the throat and discomfort when swallowing. Sore throat is not a disease, but can be a symptom of one of many different diseases.


The following conditions are often the cause of a sore throat:

Streptococcal pharyngitis (beta-haemolytic streptococcal infection).

Mouth sores.





Infectious mononucleosis ... Some childhood diseases caused by viral infections such as chickenpox, measles, mumps ...

Some sinus infections also cause a sore throat, although more rarely.


Based on the timing of the symptoms. Most sore throats due to acute streptococcal and viral infection will subside within 5 to 7 days.

Based on the general symptoms of the disease.

For example, symptoms such as high fever, sweating, muscle aches, fatigue ... can all indicate a more serious infection.

Use a light to observe directly in the throat, look for signs of tonsillitis (pustular spots ...) or infectious mononucleosis (white plaque like milk ...).

Touch the lymph nodes in the neck to determine if there is an enlarged swelling.

The majority of tests are usually of no diagnostic value in sore throats, because by the time the test results (after a few days) most patients are in remission. However, the blood test is particularly important in the diagnosis of infectious mononucleosis. In the case of a negative first test, it is necessary to repeat it 3 weeks later, as at this point the disease becomes more detectable. If the result is negative but the patient shows no signs of remission after 1 to 2 weeks, the test should be repeated.

Infectious mononucleosis is often thought of when a white membrane above the tonsils is detected. Lymph nodes in the neck are often felt enlarged to be touched by touching. Often there are petechiae on the palate and also can detect hepatosplenomegaly.

Ulcers in the mouth also cause a sore throat, detected by direct observation. Most mouth ulcers are benign, but if the ulcer persists for more than 6 weeks, the possibility of cancer should be considered.


In cases of viral infections, patients only need to use pain relievers and rinse mouth with antibiotic solution.

The cases of streptococcal infections if treated immediately with penicillin will be able to reduce symptoms of the disease within 24 hours. However, there is no method of differential diagnosis between viral and streptococcal infections, and therefore it is impossible to use penicillin without sufficient differential diagnosis basis.

When the patient shows signs of toxicity, an antibiotic that is effective against streptococci, such as penicillin, can be given, or erythromycin 250mg 4 times daily for 5 consecutive days.

Cases of tonsillitis also cause a sore throat as one of the main symptoms. Good treatment of the tonsils will relieve a sore throat within 24 hours. If symptoms persist, or pus on the tonsils is observed, especially one swelling of the tonsils, the patient should be referred to a specialist for immediate treatment. Some severe cases require surgery to remove the tonsils.

Infectious mononucleosis only treats symptoms with analgesics and gives the patient rest. Avoid antibiotics, as this can cause redness in the skin. Follow up and send blood tests to get an accurate diagnosis before deciding to treat with antibiotics.

If a patient taking carbimazole (the drug for hyperthyroidism) has a sore throat, neutropenia should be thought of immediately. Send complete blood count test right away to confirm.

Oral ulcers are managed with good oral hygiene. Gargle with salt water or an antiseptic solution. Antifungal antibiotics, such as 1ml of nystatin, are prescribed four times daily for signs of thrust.