Pharyngitis / strep throat

by | Apr 1, 2022 | Primary Care

Close-up of a person holding their throat in discomfort, representing sore throat pain and the need for evaluation and treatment.

Sore Throat and Pharyngitis: Causes, Symptoms, and When to See a Doctor

A sore throat (pharyngitis) can have many causes—both infectious (viruses and bacteria) and noninfectious (irritants or medical conditions). Understanding the cause of your sore throat is key to getting the right treatment and preventing complications.

Viral Causes of Sore Throat

Most sore throats are viral. Common viruses include:

  • Adenoviruses

  • Coronaviruses

  • Influenza A and B

Along with throat pain, viral infections may cause:

  • Runny or congested nose

  • Red or irritated eyes

  • Cough

  • Hoarseness

Strep Throat: When It’s Bacterial

One of the most common bacterial causes of sore throat is Group A Streptococcus (GAS), which causes strep throat.

Typical strep throat symptoms include:

  • Severe throat pain

  • Fever over 100.4°F

  • Swollen lymph nodes in the neck

  • White patches of pus on the back of the throat

  • Rash (in some cases)

Unlike viral infections, strep throat usually does not cause a cough, runny nose, or red/itchy eyes.

Diagnosing and Treating Sore Throat

Viral Pharyngitis

When a viral infection is suspected, treatment is supportive and may include:

  • Zinc lozenges

  • Honey

  • Warm salt water gargles

  • Adequate hydration

Recovery generally occurs within 5–7 days.

Strep Throat

Strep throat is diagnosed by:

  • Clinical exam

  • Rapid strep test or throat culture

If positive, antibiotics are prescribed. Most patients start feeling better within 24–72 hours of starting treatment.

Noninfectious Causes of Sore Throat

Not all sore throats are caused by infection. Other causes can include:

  • Allergies

  • Sinusitis

  • GERD (acid reflux)

  • Smoking or secondhand smoke exposure

  • Dry air

  • Trauma or irritation

  • Certain medications

When to Seek Urgent Medical Care

Seek immediate care if you have:

  • Muffled or “hot potato” voice

  • Difficulty breathing

  • Drooling

  • Severe neck pain or swelling

  • Toxic appearance (very ill-appearing)

In the era of COVID-19, it may be difficult to distinguish viral causes from COVID-related sore throat, so monitor symptoms closely and seek care if symptoms do not improve within 24–48 hours.

Compassion Primary Care Can Help

If your sore throat is not improving or you need a rapid strep test, call or text Compassion Primary Care. You can schedule a non-member appointment or become a member for ongoing care.

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