The medical terms for sore throat are pharyngitis (inflammation of the throat), laryngitis (inflammation of the larynx, or voice box), and tonsillitis (inflammation of the tonsils).
The throat, or pharynx, is a tubelike passageway that separates into the breathing and digestive tracts. It is made of smooth muscle and lined with a mucous membrane. The throat facilitates speech by changing shape to allow the formation of vowel sounds. It also contains openings for the hearing (eustachian) tubes, nasal space (posterior pares), larynx, gullet (esophagus), and the tonsils.
Most sore throats are caused by viruses or bacteria. Other causes may be a local irritation, such as exposure to cigarette smoke, environmental pollutants, dust, or dry winter air. A long episode of screaming may give rise to a sore throat. A sore throat can also be caused by an abscess in the back of the throat or on the tonsils.
Childhood sore throats occur most often in late winter and early spring. A sore
throat may be accompanied by a head cold, runny nose, or ear infection. The
majority of sore throats are minor viral illnesses that can be treated easily
at home. However, about one-third of childhood sore throats are diagnosed as
"strep" throat, an infection caused by the bacteria Streptococcus.
The strep bacteria is highly contagious and persistent. Strep throat can run
through a family like wildfire. The distinguishing signs and symptoms of strep
infection, as opposed to a viral infection, are not always consistent.
Definitive diagnosis of a strep infection must therefore be based on a
throat culture. But there are some general features that can help you make
an initial evaluation of your child's sore throat.
If your child's symptoms are characteristic of a strep infection, call your
physician. Your doctor can then diagnose your child's condition by performing
a throat culture and prescribe appropriate treatment. Because the streptococcus
bacteria is so highly contagious, it may be wise to check other family members
for strep symptoms, too. If left untreated, a strep infection can lead to a
number of complications. The most serious of these is rheumatic fever, an
inflammatory disease that can cause heart damage. If you have a child who has already had a case of rheumatic fever, call your physician immediately if she develops a sore throat of any kind.
A strep infection may also be accompanied by scarlet fever. This illness begins with a fever, sore throat, headache, and possibly vomiting. Twelve hours to two days after symptoms begin, the child will develop a characteristic red rash that feels like fine sandpaper to the touch. The rash usually appears first on the neck, under the arms, behind the knees, and in the groin area, and then it spreads to the extremities. It lasts for about seven days, after which the skin begins to peel or flake off. Another common sign of scarlet fever is a red, swollen "strawberry tongue." If you suspect your child's sore throat may be related to a case of scarlet fever, call your physician.
A throat culture provides the only conclusive diagnosis of streptococcus infection. Using a swab, the physician gently removes mucus from the back of the throat for examination. In a modern laboratory, a culture can be done very quickly, and the results can be in your doctor's hands within twenty-four hours. A chemically based test, known as "quick-strep," can give a tentative answer in fifteen to twenty minutes. This test is only 85- to 90-percent accurate, however, and will miss a few cases. A quick-strep test should therefore always be backed up with a regular throat culture, especially when the initial results are negative. A newer test, called Strep OIA, also gives a result in fifteen minutes, but is more sensitive. According to the manufacturer, BioStar Medical Products, it yields accurate results and no backup throat culture is required.