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Symptoms and Signs of Sore Throat

Doctor's Notes on Sore Throat

Sore throat describes irritation of the structures of the throat, including the pharynx (the area of the throat behind the soft palate of the mouth), the tonsils, the larynx (the top part of the windpipe, or trachea), and rarely, the epiglottis (a flap in the throat that keeps food from going into the lungs). Causes of sore throats include viral or bacterial infections, smoking, gastroesophageal reflux disease (GERD), post-nasal drip, oral thrush, breathing through the mouth, or serious illness such as some cancers or AIDS.

Depending on the cause, symptoms that may accompany a sore throat include fever, headache, nausea, vomiting, feeling unwell (malaise), pain with swallowing, hoarse voice, cough, runny nose, pus on the surface of the tonsils, throat redness, tender and swollen lymph nodes in the neck, drooling or spitting (as swallowing becomes too painful), difficulty breathing, or vesicles (bubbles of fluid on a red base) in the mouth or throat.

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 2/26/2019

Sore Throat Symptoms

Symptoms of sore throat can be generalized symptoms that occur throughout the body such as fever, headache, nausea, and malaise. These may be present with either a viral or bacterial infection.

Symptoms specific to the throat include pain with swallowing for pharyngitis and a hoarse voice when laryngitis is present. Cold viruses tend to cause more coughing and runny nose than strep throat.

Signs of sore throat include the following:

  • Pus on the surface of the tonsils (can happen with bacteria or viruses)
  • Redness of the oropharynx (the pharynx viewed though the mouth)
  • Tender and swollen lymph nodes in the neck ("glands") 
  • Drooling or spitting (as swallowing becomes too painful)
  • Difficulty breathing (inhaling can be especially difficult when the passage through the pharynx or larynx becomes too narrow for a normal stream of air)
  • Vesicles (bubbles of fluid on a red base) in the oral cavity or oropharynx may indicate the presence of coxsackie virus or herpes simplex virus

Two-thirds of people with strep throat have only redness with no pus on the tonsils.

Sore Throat Causes

A sore throat can have many causes including:

  • Common viruses, including the viruses that cause mononucleosis (mono) and the flu. Some viruses can also produce blisters in the mouth and throat ("aphthous stomatitis").
  • Infection of the tonsils or adenoids.
  • Breathing through the mouth or smoking can produce throat dryness and soreness.
  • Gastroesophageal reflux disease (GERD) while lying down or sleeping.
  • Sinus drainage (post-nasal drip) from allergic or chronic sinusitis.
  • Bacterial infections. The two most common bacteria to cause a sore throat are Streptococcus (which causes strep throat) and Arcanobacterium haemolyticum. Arcanobacterium causes sore throats mainly in young adults and is sometimes associated with a fine red rash.
  • Sore throat appearing after treatment with antibiotics, chemotherapy, or other immune-compromising medications may be due to the yeast Candida, commonly known as "thrush."
  • A sore throat lasting for more than two weeks can be a sign of a serious illness, such as throat cancer or AIDS.

Sore Throat or Strep Throat? How to Tell the Difference Slideshow

Sore Throat or Strep Throat? How to Tell the Difference Slideshow

Your throat aches and burns. It’s painful to swallow. You know something is wrong, but how bad is it? Will it get better without antibiotics? Or will you need to visit the doctor?

This article is designed to help you find relief from your sore throat, and discover whether or not you likely have strep throat symptoms. You will find the telltale signs of strep throat and the common sore throat, as well as treatment options for both.

What Is Strep Throat?

Unlike the common sore throat, strep throat is caused by a bacterial infection. A Streptococcus bacteria (called "group A strep") infects the throat and the tonsils, and it will quickly respond to antibiotics. It’s important to distinguish strep throat from sore throat because treatment for both is very different.

What Is the Common Sore Throat?

A sore throat can be quite painful, but it is not as painful as strep throat. Unlike strep throat, the common sore throat is usually caused by a virus. This means it will not respond to antibiotics.

Even if it’s not strep throat, you may need to see a doctor for sore throat relief. It’s time to see the doctor if your sore throat

  • lasts longer than a week,
  • keeps coming back,
  • makes your voice hoarse for more than two weeks,
  • causes dehydration, or
  • worries you in some other way.

Read along to find what symptoms distinguish a common sore throat from strep throat.


Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.