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Sore throat - acute - Management
How should I manage someone with persistent sore throat?
- Reconsider the initial diagnosis.
- Consider alternative diagnosis or further investigation if the individual has not responded to a course of antibiotics.
- Consider cancer if the sore throat is persistent, especially if there is a neck mass.
- Refer urgently anyone with:
- An unexplained persistent sore or painful throat. Persistent would refer to a time frame of 3 to 4 weeks.
- Red, or red and white patches, or ulceration or swelling of the oral/pharyngeal mucosa for more than 3 weeks.
- Pain on swallowing or dysphagia for more than 3 weeks.
- Suspect infectious mononucleosis if sore throat and lethargy persist into the second week, especially if the person is 15–25 years of age. Request a full blood count, differential white cell count and blood film to look for mononuclear leucocytosis, and a Monospot test to look for heterophile antibodies if the person wishes to be tested.
- Consider non-infectious causes of sore throat (for example, gastro-oesophageal reflux disease, chronic irritation from cigarette smoke, alcohol, or hayfever).
In depth
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