Print Print
CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.

Sore throat - acute - Background information
Non-infectious causes

  • Non-infectious causes of acute sore throat may present as an inflammatory pharyngitis or pain in the throat:
    • Physical irritation (e.g. from a nasogastric tube) [Kenealy, 2007].
    • Hayfever (rarely) [Becker, 2007; Kenealy, 2007].
    • Stevens Johnson syndrome is a serious illness of sudden onset caused by a severe reaction to medication. It presents with a high fever, arthralgia, myalgia and extensive erythema multiforme of the trunk. Extensive bullae form in the mouth followed by erosion and a grey–white membrane [Breathnach, 2004].
    • Kawasaki disease usually presents with fever and the diagnosis is established on the presence of clinical criteria. Throat symptoms may occur [Saulsbury, 2005].
    • Oral mucositis secondary to radiotherapy or chemotherapy, which may become secondarily infected [Joshi, 2002]. For more information see the CKS topic on Palliative cancer care - oral.
    • Haematological disorders [Viani and Donnelly, 1998]:
      • Leukaemia: ulceration and haemorrhage of the mucous membrane of the pharynx may occur.
      • Aplastic anaemia: sloughing and ulceration of the mouth and pharynx may occur.
    • Some drugs can cause blood disorders (e.g. neutropenia, agranulocytosis, thrombocytopenia) which predispose the individual to infections. The person may present with an acute sore throat [BNF 54, 2007].
      • Examples of such drugs are: cytotoxic drugs, carbimazole, clozapine, and sulfasalazine.

© NHS Institute for Innovation and Improvement