SORE THROAT

By Adedeji Adeyanju

OVERVIEW
A sore throat is pain, scratchiness or irritation of the throat that often worsens when you swallow. The most common cause of a sore throat (pharyngitis) is a viral infection, such as a cold or the flu. A sore throat caused by a virus resolves on its own.

Strep throat (streptococcal infection), a less common type of sore throat caused by bacteria, requires treatment with antibiotics to prevent complications. Other less common causes of sore throat might require more complex treatment.

SYMPTOMS
Symptoms of a sore throat can vary depending on the cause. Signs and symptoms might include:

-Pain or a scratchy sensation in the throat
- Pain that worsens with swallowing or talking
- Difficulty swallowing
- Sore, swollen glands in your neck or jaw
- Swollen, red tonsils
- White patches or pus on your tonsils
- Hoarse or muffled voice

Common infections causing a sore throat might result in other signs and symptoms, including:

- Fever
- Cough
- Runny nose
- Sneezing
- Body aches
- Headache
- Nausea or vomiting

When to see a doctor

Take the child to a doctor if the child sore throat doesn't go away with the first drink in the morning....

Get immediate care if a child has severe signs such as:

- Difficulty breathing
- Difficulty swallowing
- Unusual drooling, which might indicate an inability to swallow.

For an adult, it is very important to see doctor if you have a sore throat and any of the following associated problems occur....

- A sore throat that is severe or lasts longer than a week
- Difficulty swallowing
- Difficulty breathing
- Difficulty opening the mouth
- Joint pain
- Earache
- Rash
- Fever higher than 101 F (38.3 C)
- Blood in saliva or phlegm
- Frequently recurring sore throats
- A lump in the neck
- Hoarseness lasting more than two weeks

CAUSES
Viruses that cause the common cold and flu (influenza) also cause most sore throats. Less often, bacterial infections cause sore throats.

Viral infections

Viral illnesses that cause a sore throat include:

- Common cold
- Flu (influenza)
- Mononucleosis (mono)
- Measles
- Chickenpox
- Croup — a common childhood illness characterized by a harsh, barking cough

Bacterial infections

A number of bacterial infections can cause a sore throat. The most common is Streptococcus pyogenes, or group A streptococcus, which causes strep throat

Other causes

Other causes of a sore throat include:

Allergies. Allergies to pet dander, molds, dust and pollen can cause a sore throat. The problem may be complicated by postnasal drip, which can irritate and inflame the throat.

Dryness. Dry indoor air, especially when buildings are heated, can make your throat feel rough and scratchy, particularly in the morning when you wake up. Breathing through your mouth — often because of chronic nasal congestion — also can cause a dry, sore throat.

Irritants. Outdoor air pollution can cause ongoing throat irritation. Indoor pollution — tobacco smoke or chemicals — also can cause a chronic sore throat. Chewing tobacco, drinking alcohol and eating spicy foods also can irritate your throat.
Muscle strain. You can strain muscles in your throat by yelling, such as at a sporting event; talking loudly; or talking for long periods without rest.

Gastroesophageal reflux disease (GERD). GERD is a digestive system disorder in which stomach acids or other contents of the stomach back up in the food pipe (esophagus). Other signs or symptoms may include heartburn, hoarseness, regurgitation of stomach contents and the sensation of a lump in your throat.

HIV infection. A sore throat and other flu-like symptoms sometimes appear early after someone is infected with HIV. Also, someone who is HIV-positive might have a chronic or recurring sore throat due to a secondary infection, such as a fungal infection called oral thrush and cytomegalovirus (CMV) infection, a common viral infection that can be serious in people with compromised immune systems.

Both oral thrush and CMV can occur in anyone, but they're more likely to cause a sore throat and other symptoms in people with weakened immune systems.

Tumors. Cancerous tumors of the throat, tongue or voice box (larynx) can cause a sore throat. Other signs or symptoms may include hoarseness, difficulty swallowing, noisy breathing, a lump in the neck, and blood in saliva or phlegm.

Rarely, an infected area of tissue (abscess) in the throat causes a sore throat. Another rare cause of a sore throat is a condition that occurs when the small cartilage "lid" that covers the windpipe swells, blocking airflow (epiglottitis). Both causes can block the airway, creating a medical emergency.

RISK FACTORS

Although anyone can get a sore throat, some factors make one more susceptible, including:

Age. Children and teens are most likely to develop sore throats. Children are also more likely to have strep throat, the most common bacterial infection associated with a sore throat.

Exposure to tobacco smoke. Smoking and secondhand smoke can irritate the throat. The use of tobacco products also increases the risk of cancers of the mouth, throat and voice box.

Allergies. Seasonal allergies or ongoing allergic reactions to dust, molds or pet dander, make developing a sore throat more likely.

Exposure to chemical irritants.  Particles in the air from burning fossil fuels and common household chemicals can cause throat irritation.

Chronic or frequent sinus infections.  Drainage from your nose can irritate your throat or spread infection.

Close quarters. Viral and bacterial infections spread easily anywhere people gather, whether in child care centers, classrooms, offices or airplanes.

Weakened immunity. You're more susceptible to infections in general if your resistance is low. Common causes of lowered immunity include HIV, diabetes, treatment with steroids or chemotherapy drugs, stress, fatigue, and poor diet.

PREVENTION
The best way to prevent sore throats is to avoid the germs that cause them and practice good hygiene. Follow these tips and teach your child to do the same:

- Wash your hands thoroughly and frequently, especially after using the toilet, before eating, and after sneezing or coughing.
- Avoid sharing food, drinking glasses or utensils.
- Cough or sneeze into a tissue and throw it away. When necessary, sneeze into your elbow.
- Use alcohol-based hand sanitizers as an alternative to washing hands when soap and water aren't available.
- Avoid touching public phones or drinking fountains with your mouth.
- Regularly clean telephones, TV remotes and computer keyboards with sanitizing cleanser. When you travel, clean phones and remotes in your hotel room.
- Avoid close contact with people who are sick.
- As a Clinical/laboratory officer,  please USE PERSONAL PROTECTIVE EQUIPMENT ALWAYS.

DIAGNOSIS

Diagnosis of Sore Throat starts with physical examinations by Medical Officer that will include:

- Using a lighted instrument to look at the throat, and likely the ears and nasal passages
- Gently feeling (palpating) the neck to check for swollen glands (lymph nodes)
- Listening to patients/individual with sore throat symptoms breathing with a stethoscope

Throat Swab {Laboratory Diagnosis}
With this simple test, the doctor rubs a sterile swab over the back of the throat to get a sample of secretions. The sample will be checked in a lab for streptococcal bacteria, the cause of strep throat. Many clinics are equipped with a lab that can get a test result within a few minutes. However, a second, often more-reliable test is sometimes sent to a lab that returns results within 24 to 48 hours.[Throat Swab MCS]

If the rapid, in-clinic test comes back positive, then the individual almost certainly have a bacterial infection. If the test comes back negative, then the patient likely have a viral infection. The doctor might wait, however, for the out-of-clinic lab test to determine the cause of the infection.

TREATMENT

A sore throat caused by a viral infection usually lasts five to seven days and doesn't require medical treatment. However, to ease pain and fever, many people turn to acetaminophen (Tylenol, others) or other mild pain relievers. Use acetaminophen for the shortest time possible and follow label directions to avoid side effects.

Consider giving children over-the-counter (OTC) pain medications designed for infants or children. These include acetaminophen (Tylenol, Infant's Feverall, others) or ibuprofen (Pediatric Advil, Motrin Infant, others) to ease symptoms.

Use caution when giving aspirin to children or teenagers. Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition, in such children.

Treating bacterial infections
If the sore throat is caused by a bacterial infection, doctor will prescribe antibiotics.

You must take the full course of antibiotics as prescribed even if the symptoms are gone. Failure to take all of the medication as directed can result in the infection worsening or spreading to other parts of the body. Not completing the full course of antibiotics to treat strep throat can increase a child's risk of rheumatic fever or serious kidney inflammation.

Talk to your doctor or pharmacist about what to do if you forget a dose.

Other treatments
If a sore throat is a symptom of a condition other than a viral or bacterial infection, other treatments will likely be considered depending on the diagnosis.

Lifestyle and home remedies
Regardless of the cause of sore throat, these at-home care strategies can help  ease sore throat symptoms:

- Rest. And rest your voice.
- Drink fluids. Fluids keep the throat moist and prevent dehydration. Avoid caffeine and alcohol, which can dehydrate you.
- Try comforting foods and beverage.
- Warm liquids — broth, caffeine-free tea or warm water with honey — and cold treats such as ice pops can soothe a sore throat.
- Gargle with saltwater. A saltwater gargle of 1/4 to 1/2 teaspoon of table salt to 4 to 8 ounces of warm water can help soothe a sore throat. Gargle the solution and then spit it out.
- Humidify the air. Use a cool-air humidifier to eliminate dry air that may further irritate a sore throat or sit for several minutes in a steamy bathroom.
- Consider lozenges or hard candy.  Either can soothe a sore throat, but don't give them to children age 4 and younger because of choking risk.
- Avoid irritants. Keep your home free from cigarette smoke and cleaning products that can irritate the throat.

Alternative medicine
Although a number of alternative treatments are commonly used to soothe a sore throat, evidence is limited about what works. If you need an antibiotic for a bacterial infection, don't rely on alternative treatments alone.

Check with your doctor before using any herbal remedies, as they can interact with prescription medications and may not be safe for children, pregnant women and people with certain health conditions.

Herbal or alternative products for a sore throat are often packaged as teas, sprays or lozenges. Common alternative remedies include:

Slippery elm
Licorice root
Marshmallow root
Honeysuckle flower and other Chinese medicine herbs