Sore Throat

A sore throat is usually a minor viral illness that clears in a few days. The important thing is recognising the few cases that need antibiotics — because untreated streptococcal throat in children can lead to rheumatic fever and rheumatic heart disease, which are still present in India.

Typical causes

• Viral (most common) — cold viruses, influenza, COVID-19, infectious mononucleosis. Runny nose, cough, sometimes mild fever.
• Bacterial — most commonly Group A streptococcus — sudden sore throat, high fever, swollen tonsils with white patches, tender neck glands, usually no cough or runny nose. More typical in children 5–15.
• Allergy, reflux, dry air, smoke, overuse of voice.

When antibiotics help

• Suspected streptococcal throat — especially in children — deserves a clinical assessment. A throat swab / rapid test may be done.
• A 10-day course of penicillin-class antibiotics prevents rheumatic fever; this is one of the few clear "must-treat" infections in community care.
• Don't self-start leftover antibiotics — wrong drug, wrong length, and contributes to resistance.
• Most adult sore throats — viral — don't need antibiotics.

Home care

• Warm salt-water gargles several times a day.
• Plenty of fluids, rest.
• Paracetamol-class pain relief for pain/fever.
• Throat lozenges, warm honey-and-lemon drinks (honey only for children over 1 year).
• Avoid smoking, secondhand smoke, and irritants.

See a doctor

• Sore throat lasting more than 5–7 days, high fever, rash, or difficulty swallowing.
• Difficulty breathing, drooling, muffled voice, unable to open mouth — possible peritonsillar abscess or epiglottitis — urgent.
• Unilateral severe pain, tongue deviation, or neck swelling.
• A child with fever + sore throat + joint pains, chest pain, or skin nodules weeks later — rule out rheumatic fever.
• Unexplained sore throat > 3 weeks, especially in smokers/tobacco chewers, a lump in the neck, or voice change — see ENT (screen for throat cancer).