Pharyngitis is inflammation of the pharynx, which is the back part of the throat. It can cause symptoms such as sore throat, difficulty swallowing, redness and swelling in the throat, and fever.

The most common causes of pharyngitis are viral infections, such as the flu or common cold, or bacterial infections, most often caused by Streptococcus pyogenes (strep A). However, it can also develop due to gastroesophageal reflux, trauma, or allergies.

Treatment for pharyngitis is usually prescribed by a primary care provider or an ear, nose, and throat (ENT) specialist. It often involves medications to reduce inflammation and relieve symptoms, or antibiotics for about 10 days when the infection is bacterial.

woman with hand on her throat and doctor checking her lymph nodes

Common symptoms

The main symptoms of pharyngitis include:

Sore throat;
Red and swollen throat;
Pain or difficulty swallowing;
Fever;
Hoarseness;
General malaise.

Depending on the cause, other symptoms may include coughing, runny or stuffy nose, headache, swollen or tender lymph nodes in the neck, or pus in the throat.

In babies and children, pharyngitis may also cause refusal to eat or drink, vomiting, diarrhea, or stomach pain.

Confirming a diagnosis

Pharyngitis is diagnosed by a primary care provider or ENT specialist through an assessment of symptoms, medical history, and a physical exam of the throat.

In some cases, the doctor may send a throat culture for analysis in the lab in order to identify the microorganism causing the infection. This helps determine the most appropriate treatment for pharyngitis.

Possible causes

The main causes of pharyngitis are:

Viral or bacterial infections;
Sexually transmitted infections (STIs), such as chlamydia or gonorrhea;
Allergies;
Trauma or throat cancer;
Gastroesophageal reflux;
Exposure to toxins.

These conditions can lead to inflammation of the pharynx, resulting in symptoms of pharyngitis.

Different types

Pharyngitis can be categorized based on the microorganism causing the infection as well as duration of symptoms:

1. Streptococcal pharyngitis

Streptococcal pharyngitis (strep throat) is caused by Streptococcus bacteria, mainly Streptococcus pyogenes (group A beta-hemolytic streptococcus).

This type of pharyngitis typically causes high fever, swollen lymph nodes, and pus in the throat.

2. Viral pharyngitis

Viral pharyngitis occurs due to infection by viruses such as rhinovirus, influenza, adenovirus, coronavirus, or parainfluenza. Less commonly, it can be caused by other viruses like Epstein-Barr, herpes simplex, or coxsackie A.

This form of pharyngitis is often associated with colds or the flu, leading to additional symptoms like runny or stuffy nose, cough, and muscle or joint pain.

3. Bacterial pharyngitis

Bacterial pharyngitis can be caused by Streptococcus pyogenes (strep A) or other bacteria, including group B Streptococcus, Chlamydia pneumoniae, Mycoplasma pneumoniae, Haemophilus influenzae, or Neisseria meningitidis.

Other less common bacteria include Chlamydia trachomatis, Arcanobacterium haemolyticum, Fusobacterium necrophorum, and Corynebacterium diphtheriae.

4. Allergic pharyngitis

Allergic pharyngitis is triggered by allergens such as mold, dust, mites, pollen, pet dander, or chemical irritants.

It can cause itching in the throat or eyes, and symptoms similar to allergic rhinitis, such as runny nose, nasal congestion, frequent sneezing, or watery eyes.

5. Gonococcal pharyngitis

Gonococcal pharyngitis is a bacterial infection caused by Neisseria gonorrhoeae, transmitted through unprotected oral sex with an infected partner.

This type of pharyngitis is often asymptomatic but may cause fever, sore throat, or swollen lymph nodes in the neck.

6. Acute pharyngitis

Acute pharyngitis can be caused by viruses or bacteria and is more common in children. Symptoms appear suddenly, and the infection usually resolves within two weeks.

7. Chronic pharyngitis

Chronic pharyngitis is more common in adults and may be caused by allergies, smoking, climate changes, metabolic or immune disorders, reflux, or chronic sinusitis.

This type causes a persistent sore throat lasting 12 weeks or longer and can be recurrent, improving and returning periodically.

Treatment options

Treatment for pharyngitis depends on the cause, and may include:

1. Increased hydration

Drinking plenty of fluids helps prevent dehydration, especially in cases of fever.

2. Rest

Rest is recommended to help the immune system fight the infection more effectively, especially in viral or bacterial pharyngitis.

3. Avoiding exposure to allergens

For allergic pharyngitis, it is important to avoid contact with allergens and maintain a clean, well-ventilated environment. This helps both treat and prevent new episodes.

4. Medications

Treatment for pharyngitis may include pain relievers and anti-inflammatory drugs to ease symptoms, or antibiotics to eliminate bacteria, depending on the cause.

In viral pharyngitis, healthcare providers often recommend pain and fever relief with acetaminophen or ibuprofen for 2 to 3 days.

In bacterial pharyngitis, antibiotics such as amoxicillin or penicillin are prescribed. It is essential to follow the full treatment as directed by your healthcare provider to completely eliminate the infection.

Home remedies

Home remedies for pharyngitis include gargling with warm salt water and drinking herbal teas, such as ginger or peppermint tea. These can help relieve sore throat and complement medical treatment.

Pharyngitis: Symptoms, Causes & Treatment