A sore throat is a frequent reason for consultation. It is a symptom rather than a disease in itself. It can be diffuse or localized to the tonsils, pharynx or larynx.

The locations of sore throat

– pharyngitis: this is an inflammation of the throat tissues (pharynx). Swallowing, speaking, or even breathing can become painful.

– in tonsillitis (tonsillitis) the pain is more localized and sits in one or both tonsils, and causes significant difficulty in swallowing. The pain can also radiate into the ear.

– epiglottitis is an inflammation of the epiglottis (small cartilaginous tongue closing the larynx during swallowing). It is rare but potentially serious because it causes breathing difficulties.

Causes and symptoms of sore throat

A sore throat is tingling, painful, or burning, and is sometimes associated with difficulty swallowing or speaking as well as other symptoms depending on the location and cause of the disease.

In 80% to 90% of cases, a sore throat is caused by a virus, in 10 to 15% of cases, sore throat is due to infection with bacteria.

Sore throat of viral origin. It can be a pharyngitis or the beginning of a viral nasopharyngitis which is then completed by coughing, sneezing and nasal obstruction as in the flu for example.

Viral tonsillitis are generally accompanied by a moderate fever (between 38 and 39 °). They can be due to many common viruses, but also to mononucleosis or herpes, measles, chickenpox …

Sore throat of bacterial origin. Several types of bacteria can infect the throat.

Strep throat (see Angina sheet) is caused by type A streptococcus (more rarely B or C). It is accompanied by fever, swelling of a tonsil, which may be red or dotted with white spots; in the neck, there is often a swollen and painful lymph node on the side of the affected amygdala. This angina can be serious when the streptococcus is of group A because it can have repercussions on the whole organism, the kidney and the heart in particular. It must therefore be treated quickly with antibiotics.

This disease most often affects young people from 5 to 15 years old, but can also affect adults.

Two very specific tonsillitis, diphtheria which has practically disappeared from developed countries with vaccination, and scarlet fever which is accompanied by a rash

Tonsillitis:

We speak of chronic tonsillitis in front of an inflammation of the tonsils generally occurring after repeated tonsillitis, responsible for pain or discomfort when swallowing little but which can increase during flare-ups. The tonsillar “crypts” can fill with hard whitish secretions, the caseum, with a foul odor.

THEepiglottitis is usually caused by the bacteria that cause pneumonia and meningitis, Haemophilus influenzae type B (Hib). This disease has become exceptional since the generalization of vaccination against Haemophilusinfluenzae in children

Irritative causes of sore throat

Sore throats can also be caused by:

• A allergic reaction animal hair, mold or pollen.
• Dry air, especially in winter when houses are heated or in summer because of air conditioning.
• Pollution or chemical irritants such as tobacco smoke or the evaporation of products such as glues, paints, household products, etc.
• Pharyngolaryngeal inflammation after vocal strain.
• Gastroesophageal reflux disease causing pharyngitis due to acidic fluid rising from the stomach to the throat.

A sore throat that persists for more than 1 week may be a sign of a more serious problem:

• HIV infection, gonococcal infection.
• The presence of a tumor pharynx or larynx.

Possible complications

Most sore throats, although uncomfortable, subside on their own within 5-7 days. A bacterial sore throat can lead to certain complications.

• A peritoneal abscess (around the tonsils) or retropharyngeal (behind the pharynx).
• Inflammation of the kidneys (glomerulonephritis).
• Rheumatic fever, which can damage the valves in the heart and other organs.

When to consult a doctor?

It is best to seek medical attention if the following symptoms are present:

• difficulty swallowing or breathing
• voice changes or a cough that lasts for more than a week
• excessive salivation (especially in children);
• swelling of the neck or tongue;
• stiff neck or difficulty opening your mouth
• blood or mucus in saliva.
• fever over 38 °
• skin rashes;
• persistent fatigue

The consultation must be all the more rapid (during the day or even in an emergency) in the event of:

• fever over 39 °
• rash
• disease or treatment disrupting immunity: HIV infection, treatment with corticosteroids, immunosuppressants or biotherapies used to treat rheumatism or chronic inflammatory bowel disease a fortiori if there are breathing difficulties

Diagnostic

It is sometimes difficult to discern a bacterial infection an viral infection with the only symptoms of sore throat. The presence (or absence) of more than one symptom is usually used by a doctor to assess the likelihood that it is a bacterial infection. It is unlikely in children under 3 years of age or when accompanied by rhinitis or conjunctivitis. Subsequently, the doctor can detect if it is an infection. streptococcus by a rapid diagnostic test, the RDT made by a sample inside the throat. In this case, treatment with antibiotics is necessary.