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Harvard Medical School

Sore Throat (Pharyngitis)

Symptoms

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

• Viral pharyngitis — Sore throat often is accompanied by other symptoms, such as:

  • A red throat

  • Runny or stuffy nose

  • Dry cough

  • Hoarseness

  • Redness of the eyes

  Children may have diarrhea.

  Some viruses cause painful sores in and around the mouth, including the lips.

• Strep throat — Strep throat and other forms of bacterial pharyngitis cause sore throat, pain with swallowing and a red throat. These symptoms tend to be more severe with Strep throat compared to viral pharyngitis. Other symptoms that often occur with Strep throat include:,

  • Fever

  • Body ache and a general sick feeling generally sick feeling

  • Headache

  • Enlarged tonsils with a white spots

  • 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, 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.

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.