[Blog](https://vittalkamath.com/blog) # Sore throat (pharyngitis) 26 May 2026 A scratchy, burning or painful feeling in the throat. ## Causes - **Viral infection:** the common cold, flu, adenovirus, mononucleosis. - **Bacterial infection:** strep throat, tonsillitis. - **Fungal pharyngitis:** occurs with immunosuppression, or long-term use of steroids or antibiotics. - **Allergy:** hay fever, allergic rhinitis. Dry indoor air and chronic mouth breathing in winter can cause a sore throat in the morning. - **Muscle strain:** overusing the voice can cause throat pain similar to pharyngitis. - **GERD:** acid reflux irritating the throat leads to a chronic sore throat. ## Symptoms - A sore, dry, scratchy throat. Pain while swallowing or speaking. - Fever, headache, fatigue, malaise, muscle aches. - Swollen lymph nodes, nasal congestion, cough, runny nose. - Hoarseness, red tonsils, white patches, spots or streaks in the throat. - Stomach upset, and blood in the spit or phlegm in severe cases. ## Diagnosis - A physical examination of the throat, tongue, ears and neck. - A rapid strep test or throat culture, to check for *Streptococcus* bacteria. ## Treatment - **Viral pharyngitis:** goes away on its own. Salt-water gargles, pain relievers like paracetamol or ibuprofen, extra fluids, rest. - **Bacterial pharyngitis:** if strep is confirmed, antibiotics like azithromycin, 500 mg once daily for three to five days (for adults), depending on the severity. - **Fungal pharyngitis:** antifungal medicines. - **Others:** treat the underlying cause — antihistamines for allergies, antacids or PPIs for GERD, voice rest for strain. **Important:** untreated strep throat can lead to kidney problems, rheumatic fever and heart-valve damage. Prompt antibiotics matter when strep is confirmed. ## When to see a doctor - Symptoms last more than a week. - Swollen lymph nodes in the neck, or pus or white patches at the back of the throat. - Blood in the spit or phlegm. - A fever of 38.3 °C or higher. - Severe neck stiffness, difficulty breathing or swallowing, drooling. ## Quick self-care for mild cases 1. A warm salt-water gargle: half a teaspoon of salt in a glass (240 ml) of warm water. 2. Honey in warm tea, to coat the throat. 3. Stay hydrated, and use a humidifier. 4. Lozenges or a throat spray for temporary relief. [All articles](https://vittalkamath.com/blog)