A sore throat can usually be seen as a symptom of an acute upper respiratory tract infection and can be viral or bacterial. It is a usually a self limiting condition and should usually resolve in one week. It may occur alone or with other symptoms such as cough, runny nose or a headache.
Cuases
- Viral or bacterial infection
- Laryngitis
-
- GORD
- Physical obstruction
- Chemical irritation
- Medication related for example a medication-induced blood dyscrasias as a result of carbimazole
COVID-19
Consider the possibility of COVID-19 and ensure that the patient tests for the virus and isolates if possible
Differential Diagnosis
Glandular Fever:
- Infectious mononucleosis (glandular fever) is a cause of viral sore throat, especially in adolescents or young adults
- Epstein-Barr virus causes the condition, which may result in up to six months of malaise- routine referral required
Quinsy
- Tonsillar abscess, requiring drainage and antibiotic treatment.
- The patient will present with a temperature and maybe unwell with one tonsil that is usually tense and enlarged-Immediate referral is necessary.
Blood dyscrasias
- For example neutropenia and agranulocytosis present as a result of bone marrow suppression that maybe due to medication i.e. Carbimazole- Urgent referral is necessary
Referral Criteria
Call 999:
- If physically unable to swallow fluids with or without excessive drooling
- Meningeal symptoms and rash Anaphylactic symptoms
- Swallowed or inhaled foreign object
GP referral needed if:
- Presented with dysphagia (difficulty in swallowing fluids and own saliva)
- Suspected Quinsy
- Potential medication-induced blood dyscrasias e.g. carbimazole (BNF carries this warning- very important)
Routine GP referral:
- Bacterial Infection – yellow/green pus, has a fever and swollen neck for more than 3 days
- Worsening symptoms > 3 days with OTC treatment*
- Glandular fever