Internal Medicine Doctors of
Mill Basin & Bergen Beach, Brooklyn

Are You Suffering From A Painful Sore Throat (Pharyngitis)?

Posted by admin on August 15th, 2013

“Sore throats are common, especially during the winter months when many viruses are circulating. Most sore throats caused by a viral infection will not require treatment, but sometimes sore throats are the result of a bacterial infection and antibiotics are needed. If you have a sore throat that is making it difficult for you to eat, drink or talk, make an appointment to come in and see me”.

-Dr. Zimilevich, MD

Although most sore throats (called pharyngitis in medical lingo) are not serious and don’t require treatment except comfort care, some sore throats require treatment with antibiotics. Generally, a sore throat caused by a bacterial infection will produce other symptoms in addition to your sore throat that might prompt you to seek medical care. The tricky part is being able to tell the difference!

Sore throats caused by viral infections

Viral infections, including the common cold, are most common during the fall and winter months when people are indoors and in crowded conditions. Sore throat may be accompanied by a runny nose, mild muscle aches, fatigue and a cough. Symptoms generally subside in 7 to 10 days. Most people with a viral sore throat are able to continue their daily activities and manage their symptoms with rest and over-the-counter remedies.

Sore throats caused by bacterial infections

Approximately 10% of the time, a sore throat in adults is caused by a microorganism called Streptococcus, commonly referred to a strep throat. If you have strep throat, you may feel quite ill. Your sore throat may be so sore that swallowing is very painful. In addition to an extremely sore throat, you may have:

• white patches (pus) visible on the back of your throat
• a fever, which may be high
• enlarged lymph glands in your neck
• little or no cough and runny nose (rhinitis)
• malaise (little energy to do anything, general sense of unwellness)

In addition to strep infection, mononucleosis can also cause an extremely sore throat, fever, and swollen lymph glands. Mononucleosis is caused by the Epstein-Barr virus. Influenza, also caused by a virus, sometimes causes sore throat and can make you feel very unwell.

What can I expect when I come to see you?

When you come in to see me complaining of a sore throat, I will want to know a little about you (if you are a new patient). I’ll need to know about your past medical history, specifically if you have any chronic health problems that can affect immunity. I’ll ask about any allergies you may have in the event that I need to prescribe a medication for your condition.

Next, I will examine you. In addition to looking at your throat to check for swelling, pus and redness, I will look in your ears and listen to your heart and lungs. I may also examine your abdomen (especially if I suspect mono, which can cause your spleen to enlarge). My examination will be focused on your throat, but may be expanded elsewhere, depending on what I suspect the problem to be.

Any of the following is worrisome and should prompt you to make an urgent appointment, as any of the following could be a sign/symptom of a serious problem:

• drooling (inability to swallow saliva or secretions)
• rash associated with fever and sore throat
• swelling that involves the tongue and neck (which could occlude your airway, making it difficult to breathe)
• breathing difficulties
• neck stiffness
• an impaired immune system

I may order diagnostic tests if I feel they are necessary, such as a complete blood count, a chest x-ray or x-ray of the soft tissues of the neck,  a rapid strep test or a culture of material from the back of your throat. A rapid strep test can determine in a few minutes if your throat is infected with the streptococcus bacterium.

If I feel that you have a viral sore throat, I will recommend symptomatic treatment, such as rest, plenty of fluids, mild pain relievers and lozenges/throat sprays/oral rinses as necessary. Antibiotics will not be helpful if you have a viral infection and may cause more harm than good.

If I suspect the cause of your sore throat is bacterial in nature, I will prescribe antibiotics such as penicillin, or an alternative antibiotic if you are allergic to penicillin. Generally you will start to feel better within 24 to 48 hours after starting the antibiotic- if you do not start to feel better within 3 days, you should come back in to see me.

If you have a very sore throat, especially if it is accompanied by any of the signs/symptoms listed above, make an appointment to come in to see me. I will be happy to evaluate your sore throat and help you determine the cause and necessary treatment.

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