Health A-Z

Medical Content Created by the Faculty of the
Harvard Medical School

Sore Throat (Pharyngitis)

Symptoms

The main symptom of pharyngitis is a sore throat. In infectious pharyngitis, other symptoms vary depending on whether the infection is viral or bacterial (usually strep throat):

• Viral pharyngitis — Sore throat often occurs with the following symptoms: pain when swallowing; redness in the throat; runny nose; stuffy nose; cough; hoarseness; redness of the eyes; and, in children, diarrhea. In some cases, there can be a painful redness around the mouth or small painful sores on the lips and inside the mouth.

• Strep throat — With strep throat and other forms of bacterial pharyngitis, sore throat can be accompanied by any of the following symptoms: fever; pain when swallowing; a generally sick feeling (malaise); headache; redness and swelling in the throat; a coating on the tonsils or tongue; and swollen, tender lymph nodes (swollen glands) in the front of the neck. Children also can have nausea, vomiting and abdominal pain.

Because symptoms of viral and bacterial pharyngitis can overlap, it may be difficult for the doctor to distinguish between them based on symptoms alone. As a general rule, however, if you have a prominent cough and nasal symptoms you are more likely to have viral pharyngitis than strep throat.

In addition to viral and bacterial pharyngitis, an infection with fungi (Candida or "yeast") sometimes can cause throat pain, difficulty swallowing and white patches inside the mouth. This throat infection, commonly called thrush, usually affects infants and people with weakened immune systems. It is relatively rare among healthy older children and adults.

A sore throat that lasts for more than a couple of weeks may be caused by acid reflux from the stomach, breathing through the mouth in a dry environment, postnasal drip or, rarely, a tumor.