Pharyngitis - viral
Pharyngitis is swelling in the throat at and just below the tonsils that causes discomfort, pain, or scratchiness. It is often called a "sore throat".
Have you ever gotten a really bad sore throat? So bad that your throat feels raw, like it's been rubbed with sandpaper? It can hurt just to swallow. Pharyngitis is a big word that basically means sore throat. It's a type of sore throat that's caused by inflammation of the pharynx. Your pharynx is a tube in the back of your throat. It sits between your tonsils and your voice box. When bacteria or viruses get into your throat, they can cause an infection that makes your pharynx swollen, tender, and red. This is called pharyngitis. Often, Group A strep bacteria cause pharyngitis, known as strep throat. The main symptom of pharyngitis is a sore throat, but you may also have other signs of an infection, such as a fever, headache, joint and muscle aches, and swollen glands in your neck. Your doctor will notice that your pharynx is swollen and red when looking at your throat. You may also need a swab called a throat culture to make sure you don't have strep throat. If you do test positive for strep throat, your doctor can prescribe an antibiotic to kill off the bacteria. There's another common type of bacteria that can cause throat infections: Fusobacterium necrophorum. I call it F-throat. Antibiotics are important for F-throat. But pharyngitis that's caused by a virus won't get better with antibiotics. You'll just need to take care of yourself and wait for your body to fight off the infection. To soothe a sore throat, drink warm liquids such as tea with honey or lemon. Gargle a few times a day with warm water mixed with about a half-teaspoon of salt. Sleep with a cool-mist vaporizer to keep your throat moist. Popsicles may be soothing. And suck on cough drops or lozenges. If your throat is really raw, you can take an over-the-counter pain reliever. Sore throats are more common during the winter months, so wash your hands often and try to not be too close to people who are sick. If you do get a sore throat, stay home and rest until you feel better, or at least until there's been no fever for 24 hours. Keep washing your hands often so you don't pass the infection to other people in your family. Pharyngitis should go away in a few days, but if it doesn't, call your doctor. Also call if you have a very high fever, a rash, or swollen glands. Get emergency help right away if you have trouble breathing.
Food passes from the mouth to the oropharynx (back of the throat) to the esophagus.
Have you ever gotten a really bad sore throat? So bad that your throat feels raw, like it's been rubbed with sandpaper? It can hurt just to swallow. Pharyngitis is a big word that basically means sore throat. It's a type of sore throat that's caused by inflammation of the pharynx. Your pharynx is a tube in the back of your throat. It sits between your tonsils and your voice box. When bacteria or viruses get into your throat, they can cause an infection that makes your pharynx swollen, tender, and red. This is called pharyngitis. Often, Group A strep bacteria cause pharyngitis, known as strep throat. The main symptom of pharyngitis is a sore throat, but you may also have other signs of an infection, such as a fever, headache, joint and muscle aches, and swollen glands in your neck. Your doctor will notice that your pharynx is swollen and red when looking at your throat. You may also need a swab called a throat culture to make sure you don't have strep throat. If you do test positive for strep throat, your doctor can prescribe an antibiotic to kill off the bacteria. There's another common type of bacteria that can cause throat infections: Fusobacterium necrophorum. I call it F-throat. Antibiotics are important for F-throat. But pharyngitis that's caused by a virus won't get better with antibiotics. You'll just need to take care of yourself and wait for your body to fight off the infection. To soothe a sore throat, drink warm liquids such as tea with honey or lemon. Gargle a few times a day with warm water mixed with about a half-teaspoon of salt. Sleep with a cool-mist vaporizer to keep your throat moist. Popsicles may be soothing. And suck on cough drops or lozenges. If your throat is really raw, you can take an over-the-counter pain reliever. Sore throats are more common during the winter months, so wash your hands often and try to not be too close to people who are sick. If you do get a sore throat, stay home and rest until you feel better, or at least until there's been no fever for 24 hours. Keep washing your hands often so you don't pass the infection to other people in your family. Pharyngitis should go away in a few days, but if it doesn't, call your doctor. Also call if you have a very high fever, a rash, or swollen glands. Get emergency help right away if you have trouble breathing.
Causes
Pharyngitis may occur as part of a viral infection that also involves other organs, such as the lungs or bowel.
Most sore throats are caused by viruses.
Symptoms
Symptoms due to or associated with pharyngitis may include:
- Discomfort when swallowing
- Fever
- Joint pain or muscle aches
- Sore throat
- Tender swollen lymph nodes in the neck
Exams and Tests
Your health care provider usually diagnoses viral pharyngitis by examining your throat. A lab test of fluid from your throat will show that bacteria (such as group A streptococcus, or strep) is not the cause of your sore throat.
Treatment
There is no specific treatment for viral pharyngitis. You can relieve symptoms by gargling with warm salt water several times a day (use one half teaspoon or 3 grams of salt in a glass of warm water). Taking acetaminophen, or an anti-inflammatory medicine such as ibuprofen, can control fever. Excessive use of anti-inflammatory lozenges or sprays may make a sore throat worse.
It is important to NOT take antibiotics when a sore throat is due to a viral infection. The antibiotics will not help. Using them to treat viral infections helps bacteria become resistant to antibiotics.
With some sore throats (such as those caused by infectious mononucleosis), the lymph nodes in the neck may become very swollen. Your provider may prescribe anti-inflammatory drugs, such as prednisone, to treat them.
Outlook (Prognosis)
Symptoms usually go away within 7 to 10 days.
Possible Complications
Complications of viral pharyngitis are extremely uncommon.
When to Contact a Medical Professional
Make an appointment with your provider if symptoms last longer than expected, or do not improve with self-care. Always seek medical care if you have a sore throat and have extreme discomfort or difficulty swallowing or breathing.
Prevention
Most sore throats cannot be prevented because the germs that cause them are in our environment. However, always wash your hands after contact with a person who has a sore throat. Also avoid kissing or sharing cups and eating utensils with people who are sick.
References
Allen CT, Nussenbaum B, Merati AL. Acute and chronic laryngopharyngitis. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 61.
Flores AR, Caserta MT. Pharyngitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 59.
Roginski MA, Atchinson PR. Upper respiratory tract infections. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 61.
Tanz RR. Acute pharyngitis. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 409.
Version Info
Last reviewed on: 2/8/2024
Reviewed by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
