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Sore Throat, Strep Throat and Tonsillitis

Pharyngitis, more commonly known as a sore throat, is typically caused by viral infections such as the cold or flu. Symptoms include a scratchy, irritated throat with pain that grows worse when swallowing. In severe cases, a sore throat may be caused by an infection such as streptococcal (strep throat) or mononucleosis.

Sore Throat Symptoms and Causes

Although soreness and pain is present with any sore throat, the type of pain and its longevity can help determine the cause. In general, a sore throat results in:

  • Discomfort and scratchiness in the throat area
  • Difficulty swallowing or a worsening of pain when swallowing or speaking
  • Dryness in the throat area
  • Hoarseness
  • Sore and/or swollen glands in the neck or jaw area
  • Swollen, red tonsils, sometimes with white patches or pus

In addition to the above symptoms, the patient may experience the following:

  • Body aches
  • Chills
  • Coughing
  • Runny nose
  • Sneezing
  • Fever
  • Headaches
  • Nausea and/or vomiting

Sore Throat Causes

Most sore throats are caused by a common cold, influenza or the mononucleosis virus. Other causes include allergies and bacterial infections such as an upper respiratory infection or strep.

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Sore Throat Treatment and Remedies

A sore throat caused by a viral infection requires no medical treatment unless it lasts longer than a few days. A persistent or worsening sore throat may be caused by a bacterial infection and may require treatment with antibiotics.

In cases of strep, a penicillin type medication or another antibiotic, is usually prescribed for a period of 7-10 days. It’s important to take the full dose for the appropriate period of time even if symptoms diminish or completely go away. Failure to take all medication as prescribed can result in a worsening or spreading of the infection. This is particularly dangerous in children where strep poses a risk of rheumatic fever.

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Strep Throat Symptoms

Strep throat, which is caused by a bacterial infection, can become serious if left untreated. It is also highly contagious. If you suspect a sore throat may be due to a strep infection, it is important to see a doctor for immediate treatment.

The following symptoms may indicate a sore throat caused by strep:

  • Swollen, tender lymph glands
  • Fatigue
  • Fever
  • Headache
  • Rash
  • Stomach ache, possibly accompanied by vomiting, especially in young children
  • Swollen, tender lymph glands
  • Fatigue
  • Fever
  • Headache
  • Rash
  • Stomach ache, possibly accompanied by vomiting, especially in young children

If you or your child experiences several or more of these symptoms, it’s important to get a diagnosis from your doctor to determine the cause. A rapid strep test may be performed, but is not always needed to start treatment. Since this test isn’t conclusive, your doctor may also consider performing a throat culture, especially if there is recurrence. The culture will take several days to evaluate, so antibiotics may be prescribed as a precaution. Depending on the circumstances, your doctor may also test for additional infections such as mononucleosis.

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Strep Throat Causes

Strep throat is caused by bacteria called streptococcus pyogenes, typically referred to as group A streptococcus. Highly contagious, strep spreads when someone with the infection sneezes or coughs, or when someone touches a contaminated surface and then transfers the bacteria through the eyes, nose or mouth.

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When to visit your nearest MD Now Urgent Care

If you suspect your sore throat may be caused by a strep infection, you should visit your MD Now Urgent Care as soon as possible. Let your doctor know if you have experienced any of the following symptoms:

  • Sore throat along with swollen, tender lymph glands
  • Sore throat lasting longer than 2 days
  • Sore throat accompanied by a rash
  • Breathing problems
  • Difficulty swallowing
  • If strep has been previously diagnosed, a lack of improvement after 1 to 2 days of antibiotics
  • Fever above 101 F (38.3 C) in older children, or any fever that lasts beyond 2 days
  • Fever, joint pain and swelling, shortness of breath or a rash following a strep infection. (These can occur up to three weeks after infection and may indicate rheumatic fever.)
  • Cola-colored urine (This can occur up to one week after a strep infection and may indicate kidney inflammation.)
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How to prepare for your visit

In preparation for your visit to MD Now, please note any symptoms, their duration and any possible sources of infection. You should also be prepared to provide key medical information, such as pre-existing health problems and any current medications you’re taking.

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What to expect during your visit

Your doctor will examine you for signs and symptoms of strep throat, including fever and enlarged lymph nodes. Your throat and tonsils will be closely examined using a tongue depressor to check for redness, swelling, white patches and pus. The presence of tiny red spots at the back of the roof of your mouth usually indicates an infection is present, whether viral or bacterial.

To determine whether bacteria, including streptococcal bacteria, are present, your doctor may opt to use one or both of the following tests:

Throat Culture – During this procedure, a sterile swab will be rubbed over the back of the throat and tonsils in order to collect sample secretions. Other than a gagging response in some patients, this is generally painless. The collected sample will be cultured in a laboratory for up to three days to determine whether bacteria are present.

Rapid Strep Antigen Test – If a throat culture isn’t possible due lack of availability, or if a more immediate result is required, your doctor may order a rapid antigen test. If the test proves positive for strep bacteria, antibiotics for strep throat will be prescribed. While this test can detect strep bacteria in minutes, it is not as reliable (with many false negatives) as a throat culture and may not catch certain strep infections, so if Strep is highly suspected they may decide not to perform this test and just treat. This is why many doctors use throat cultures to verify the results, especially in children where strep can lead to more serious complications.

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Strep Throat Treatment

Strep throat is typically treated using antibiotics such as penicillin, Amoxicillin, Azithromycin and others. These medications help relieve symptoms and prevent the bacteria from spreading, either within the patient or to others. Symptoms should improve within a day or two of the initial dose of medication. If no improvement takes place after two days, contact your MD Now physician.

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Sore Throat vs. Strep Throat vs. Tonsillitis

If a sore throat is simply the result of a cold, it will usually improve or go away within one to two days. Sometimes it will be followed by additional cold symptoms such as congestion and/or a runny nose.

If a sore throat is severe and persistent, lasting longer than two days, it may be due to the streptococcus bacteria or tonsillitis. Cases of tonsillitis will affect the tonsils, the tissue located in the back and on either side of the throat. Sometimes tonsillitis is caused by a bacterial infection such as strep.

Identifying strep is important as it may lead to more serious and painful problems like rheumatic fever, resulting in painful, inflamed joints. Strep can also cause a rash and may eventually damage the heart valves. If you suspect you may have strep, contact your MD Now physician immediately for diagnosis.

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Symptoms of Tonsillitis

Unlike a sore throat caused by a cold, tonsillitis symptoms include swelling of the tonsils and may result in yellow or white spots on tonsils indicating pus. With tonsillitis, patients may also experience:

  • Fever
  • Painful swallowing
  • Swollen lymph glands in the neck
  • Bad breath
  • Voice changes
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Treatment and Remedies for a Sore Throat from Tonsillitis

Treatment depends on whether the tonsillitis is caused by a virus or bacteria. For bacterial infections, antibiotics are usually prescribed. For viral cases, antibiotics are ineffective. The only option is to let the virus run its course. In either case, the following home and over-the-counter treatments should help with symptoms:

  • Drink lots of fluid
  • Get plenty of rest
  • Avoid spicy and crunchy foods that can irritate the throat
  • Stick to smooth, soothing foods like gelatin, soup and frozen desserts
  • Take over-the-counter pain relievers like acetaminophen, ibuprofen or naproxen. (Do not give children aspirin.)
  • Use a vaporizer
  • If symptoms worsen or show no sign of improvement, or if the patient is diabetic or immunosuppressed, please seek immediate medical attention.

For repeated tonsillitis infections, or if the tonsils interfere with sleep and breathing, your MD Now doctor may recommend an elective surgery (a tonsillectomy) to remove the tonsils.

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“The above is presented for informational purposes only and is not intended as medical advice. If you require medical advice or treatment, you should go to MD Now Urgent Care, your physician, or the nearest ER for evaluation.”

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