Sore Throat

It's fall when I write this and the sore throat season is about to be upon us.  Sore throats are common.  They seem to be due to a viral infection most commonly.  There is no specific antibiotic for a sore throat due to a virus.  However, some sore throats are the result of a bacterial infection, in particular, Group A streptococcus.

How can you know whether you have a virus or Group A Streptococcus ?  This can be difficult, but there are some clues and good warning signs.  If you have the combination of fever, swollen tender lymph nodes in your neck, and pustular appearing tonsils, then your chances of having a Group A strep infection are about 50%.  This means that about half of people with these findings have a strep throat infection and about half have a viral infection. If you look at it another way, about half of people with these symptoms will benefit from antibiotics and half will not.

Suppose you have a fever with swolen lymph nodes only, then your chances of strep throat are down around 20-30%.  If you have only a sorethroat with one of the symptoms I noted above(fever,lymph nodes, or pustular tonsils), then your chances of strep throat are down around 10-20%.  Or, looked at from a different perspective, 80-90% of people will not need an antibiotic.

So, suppose you seem to have a "simple" sore throat with none of the symptoms of fever, swollen lymph nodes, or pustular tonsils, what should you do ?

  • First, take some tylenol to control the pain. It will usually work good.  You can also use any of the anti-inflammatory medicines such as Aspirin, Ibuprofen, etc.

  • Take your temperature with a thermometer.  If it is over 100.5, you may have a more serious infection, so watch it closely and let us know if you are doing poorly.

  • To control the pain symptoms of sore throat you can also gargle with a dilute salt water solution, spray the throat with chloraseptic spray, suck on chloraseptic lozenges or any throat lozenge you have found to be helpful.  I have always liked the anise flavored tablets myself.

  • Watch for signs of this being other than a simple sore throat, such as, a cough producing lots of phlegm, tooth ache, swelling under the jaw or on the side of the face, sinus pain, ear ache, severe headache, tonsils that begin to block off the air passage, high fever over 100.5 degrees by mouth, and any change in your level of consciousness.  If these sorts of things are happening you will need to be checked up.

 

Most sore throats last around 4-6 days.  This is true even if you take an antibiotic.  You cannot expect relief from a proven strep throat overnight, it will take time !!  The reason we treat strep throat is to prevent rheumatic fever and tonsilar abscess.  The treatment is not aimed at making you feel better in reality.

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