All posts by Jennifer Urbano, MD

The Nagging Sore Throat

Over the past couple of weeks, one of the most common sick visit complaints in the office has been the nagging sore throat. The causes can be broad and range from allergies to viral or bacterial infections. One of the most common concerns among patients and providers alike is whether or not strep throat could be the cause. Strep throat is caused by the bacteria Group A Beta Hemolytic Streptococcus, which infects the structures of the throat, including the tonsils.

The data changes slightly from year to year, but the Centers for Disease Control states that upwards of 80% of sore throat symptoms are caused by non-bacterial causes, like viruses. That said, only 7-10% of sore throat symptoms can be attributed to strep throat and the remaining percentage is due a variety of even less common causes. There are four clinical criteria that increase the chances that the sore throat may be caused by strep: fever, enlarged and tender lymph nodes in the neck, absence of a cough, and pus noted on the tonsils.

A rapid strep test can be done in the office in about ten minutes and is fairly accurate, however a throat culture may be indicated based on the age of the patient and their specific symptoms. These tests are helpful in determining which patients may need antibiotics to prevent against the rare, but potential harmful effects of untreated strep which can affect the kidneys and the heart. The more concerning shift these days, however, is overuse of antibiotics for illnesses that are typically caused by viruses (see Dr. Smith’s article “Who Needs an Antibiotic?”). All of that said, please get evaluated if you have a sore throat that lasts more than a couple of days or is associated with the above symptoms that may be concerning for strep.
If you end up with a nagging sore throat this fall and it turns out to be viral, you may want to try one of my favorite home remedies (please avoid honey in children less than 12 months old): boiling a couple of ginger roots, several cinnamon sticks, and 2 tablespoons of honey in a large pot of water. You can make it more or less potent by adjusting the amount of the ingredients. It’s a recipe that was passed down from my Korean great-grandmother and it truly works!
Here is a helpful reference from the CDC that provides more information:

http://www.cdc.gov/getsmart/antibiotic-use/uri/sore-throat.html

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