Sore Throat: How to Recognise It, Treat It and Know When to See a Doctor

Sore throat, fever, discomfort when swallowing: a sore throat (tonsillitis) is one of the most common infections, especially in children. Here is how to tell a viral sore throat from a bacterial one, how to relieve it and when to see a doctor.

What is a sore throat (tonsillitis)?

A sore throat, or tonsillitis, is an acute inflammation of the tonsils and the throat (the pharynx). It shows up as throat pain, often together with fever and discomfort when swallowing. It is a very common infection, particularly in children and teenagers, but it also affects adults.

In the vast majority of cases, a sore throat is mild and clears up on its own within a few days. The main challenge is to tell apart a viral sore throat, the most common type, from a bacterial one caused by streptococcus, which may call for antibiotic treatment.

Viral or bacterial sore throat?

There are two main causes of a sore throat:

• Viral sore throat (around 70 to 80% of cases): caused by a virus, it does not require antibiotics and clears up on its own. It often comes with cold-like symptoms: runny nose, cough, hoarseness.
• Bacterial sore throat: most often caused by group A streptococcus (strep throat). It may require antibiotic treatment to prevent certain complications, especially in children.

With the naked eye, it is not always possible to tell the difference. A rapid diagnostic test (rapid strep test), done in a few minutes from a throat swab, can confirm or rule out strep throat.

Sore throat symptoms

The most common signs are:

• a sore throat, sometimes severe, with discomfort when swallowing;
• a fever, often between 38 and 40 °C;
• red tonsils or tonsils covered with a whitish coating ("pus on the tonsils");
• tender or swollen glands in the neck;
• tiredness, headaches, and sometimes tummy pain in children.

When should you see a doctor?

It is advisable to see a doctor:

• if the sore throat is severe or lasts more than 3 to 5 days;
• if there is a high or persistent fever;
• if there is difficulty swallowing, breathing or opening the mouth;
• in a child, if there is listlessness, refusal to drink or a fever that is poorly tolerated;
• if symptoms come back or get worse after an initial improvement.

A consultation allows the doctor to examine the throat, carry out a rapid diagnostic test if needed and decide on the most suitable treatment.

Treating a sore throat

Treatment depends on the cause. In every case, the symptoms are relieved: rest, hydration, pain relievers and fever reducers (such as paracetamol) for pain and fever.

If a bacterial sore throat is confirmed, an antibiotic may be prescribed. It should never be taken without medical advice: antibiotics are useless against viral sore throats, and overusing them fuels bacterial resistance.

Sore throat in children

Sore throats are especially common in children. Before the age of 3, they are almost always viral. The rapid diagnostic test is useful from that age on to avoid unnecessary antibiotics. Keep an eye on hydration, fever and general condition: a child who drinks, plays and rests well usually gets better without trouble.

Consult Dr Nathalie Gozlan

Dr Nathalie Gozlan, a general practitioner, can see you quickly for a sore throat or tonsillitis — with a home visit in the Sharon region (Netanya, Kfar Saba, Raanana, Kadima-Tzoran and the moshavim and kibbutzim of the area), or by teleconsultation anywhere in Israel, in French, Hebrew and English.

When in doubt, a consultation makes it possible to examine the throat, carry out a test if necessary and get a suitable prescription.

Frequently asked questions

This article is for information only and does not replace a medical consultation. If in doubt or in an emergency, see a doctor.