Last updated: May 20, 2019
Richard Honaker M.D.
Primary Care Physician
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Determining whether your sore throat infection is bacterial, viral or a staph infection isn’t always easy. Check out our guide to determining the cause of the tickle in your throat.
A tickle in your throat is often the first sign of illness, but what action do you need to take? Sometimes a tickle is nothing more than a symptom of a cold, other times it’s the beginning of a bacterial infection. Determining the best course of action for a sore throat isn’t always easy.
Should you visit a doctor for antibiotics or try home remedies? Is your sore throat a result of a viral, bacterial or staph infection?
At Your Doctors Online we have gathered everything you need to know to determine the cause of your painful throat, whether or not you need to speak to a doctor and how to prevent this often painful condition in the future.
What Causes Throat Irritation?
While waking up with a familiar abrasive sensation in the back of the throat is often the first sign of an illness, it is not always the case. Your throat can also become irritated by environmental allergens including:
- Cigarette smoke
- Chemical cleaners
- An allergic reaction to pollen, dust or pet dander
- Inflammation from post nasal drip
- Mouth breathing
- Long periods of talking, singing or yelling
- Dryness in the air
Viral Throat Infections
Mild throat pain is often the first sign that you have picked up a cold or flu (influenza) virus. This type of virus can be picked up when tiny moisture droplets are put into the air when an infected person coughs or sneezes. Many schools and daycare centers are hot spots for viruses to spread.
Unfortunately colds are very common. In fact there are an estimated billion colds in the U.S. each year. While these illnesses can strike all year around, they are more likely to occur in the winter and rainy seasons.
You are the most contagious in the first two to three days after contracting a cold. It is important to limit your exposure to others during this time and wash your hands diligently. Many public places can be breeding grounds for viruses if an infected person leaves the virus on a surface and another person touches the surface and then their face.
Signs and Symptoms of a Viral Throat Infection
No two viruses are exactly alike and therefore the symptoms associated with each and every virus will vary. Generally speaking, when you have contracted a viral throat infection you are likely to experience one or more of the following symptoms:
- A painful or scratchy sensation in the throat when talking or swallowing
- Swollen and possibly painful glands in the neck and jaw area
- Your voice may sound muffled or hoarse
- If you have tonsils, they may become red or have white spots
Bacterial throat Infection
While not the only type of bacteria that can cause a throat infection, the most common is Streptococcus pyogenes, or group A streptococcus, which causes strep throat.
Similar to a viral infection, a bacterial infection is spread when moisture droplets travel through the air after an infected person coughs or sneezes.
This type of throat infection can occur in adults, but is more likely seen in those ages between the ages of 5 and 15.
Staph Throat Infection
While less common, it is possible that your sore throat could be caused by a bacteria that is present in 20 to 30 percent of healthy people.
Staphylococcal bacteria can be found on the skin or inside the nose of 20 to 30 percent of healthy people. It can also hide inside the mouth, in the breast tissue and the anus and urinary and upper respiratory tracts.
While more commonly associated with skin, this type of bacteria can grow in the throat and cause abscesses (commonly found on the tonsils). These abscesses will eventually burst and eliminate pus which will further spread the infection.
Signs and Symptoms of a Staph Throat Infection
Many of the symptoms of this bacterial infection are similar to a strep throat infection with a few important distinctions.
- The throat will appear red with pain and swelling
- There will be abscesses in the area which may produce pus
- You will have difficulty swallowing
Diagnosis for a Bacterial Throat Infection
In order to determine the cause of the infection your healthcare practitioner will need to examine your throat as well as swab for a quick strep test. If the results of the quick strep test are negative, then further examination at a laboratory can determine if you have a staph infection.
With any bacterial infection, it is important to take antibiotics to clear up the infection. Your discomfort should subside after 24-48 hours of antibiotics, but it is important to continue for the full course of treatment.
Serious Side Effects
In a small amount of serious cases, a sore throat can be a sign of something much more sinister.
An occasional sore throat is normal, but the regular appearance of a sore throat can be a sign of a serious condition. A UK case study has found that it can be an early warning sign of cancer of the larynx.
In addition, flu-like symptoms are often the first sign of HIV. In HIV-positive patients, chronic sore throats can also occur as part of a secondary infection.
Gastroesophageal reflux disease (GERD) is a digestive system disorder causes stomach acid and contents to back up into the esophagus and cause pain in the throat.
PANDAS is a autoimmune condition that can be initiated with a strep throat infection. This condition is normally seen in children and can cause the sudden onset of Obsessive Compulsive Disorder symptoms after a strep throat.
Do you Need to Consult a Doctor?
One of the most important distinctions to make with a sore throat is whether the infection is viral or bacterial. This is because a viral infection can be treated with home remedies and plenty of rest and bacterial infections require antibiotics to treat the infection.
This is an important distinction as public spaces (such as doctor’s offices) can be a breeding ground to further spread the virus. Visiting a doctor’s office does not always answer this question.
Antibiotics are essential in battling bacterial infections but unnecessary for viral throat infections.
According to a 2016 Center for Disease Control (CDC) study, 1 in 3 prescriptions written in the United States are unnecessary. This adds up to an estimated 47 million unnecessary prescriptions written each year.
It is estimated that 44 percent of outpatient prescriptions written each year are to treat respiratory infections. Sadly, 30 percent are believed to be unnecessary.
Taking unnecessary antibiotics can worsen your illness by causing allergic reactions or diarrhea. It also increases the risk of a build up of antibiotic resistance.
What is Antibiotic Resistance?
Misuse of antibiotics is increasing the growing global concern over antibiotic resistance according to the World Health Organization, (WHO).
Antibiotic resistance can happen to anyone regardless of age, but it does not in people or animals themselves, but rather in the bacteria itself.
Antibiotics are used to treat bacterial infections but antibiotic resistance can occur if the bacteria changes in response to the medication. The bacteria can gain the ability to better resist the antibiotics and then becomes much harder to treat.
It is for this reason that it is important to only use antibiotics for bacterial infections and to completely finish each dose as prescribed by your healthcare professional.
Sore Throat vs. Strep Throat: Is it Possible to Diagnose at Home?
Making an appointment to see your healthcare professional can be a time consuming and annoying task. Not only do you have to have a healthcare professional that is accessible and available, but you have to take time away from resting your body in order to attend your appointment.
Luckily there are better ways to get in touch with a doctor from the comforts of home. At Your Doctors Online, you can chat with one of our doctors for free without leaving your home or risking your health.
We are not the only ones looking at the future of healthcare. A recent study considered the possibility of an app to self-diagnose strep throat from home. This study married two simple questions the patient could ask themselves along with the prevalence of strep throat in the area. While the technology has yet to be fully realized, the study had great results.
In the study 90 percent of patients shown to be “low-risk” based on the test questions also had negative clinical test results.
The two questions that the patients needed to ask themselves were:
- Do you have a cough?
- Have you had a fever in the last 24 hours?
These two questions were able to pinpoint the symptoms to either a viral or bacterial infection with a fairly high success rate. This is because a cough is associated with a cold or flu and not with a strep throat. If a patient had a cough it was more likely that they had a viral infection and did not need to see a doctor
Fever, however, is associated with infections and more likely to be associated with a bacterial infection. If you are unsure about whether your sore throat is due to a strep infection, you can always start with asking yourself these two questions. You can also always consult one of our doctors for free.
Other common cold and flu symptoms:
While coughs are a common sign you have picked up a cold or flu virus, it is usually one of many. If you have a cold or flu you may also experience one or more symptoms.
- Runny nose
- Body Aches
- Nausea or vomiting
While the cold and flu is often spread during the cold and rainy seasons, it is not the only viral infection that can lead to a sore and scratchy throat. You symptoms could also be the result of:
- Croup (this common childhood illness is characterized by a distinctive barking cough)
- Mononucleosis (mono)
Natural Ways to Encourage Healing
While bacterial throat infections require antibiotics to heal, viral throat infections simply need to run their course through your body. Fortunately, there are steps you can take to naturally encourage your body to heal itself as well as alleviate the discomfort from the virus.
- Sip on warm drinks to soothe your throat suck as herbal tea with honey
- Enjoy cold treats such as popsicles to numb the pain
- Use over the counter throat sprays
- Suck on lozenges to ease throat pain (this is not recommended for children 3 and under due to the risk of choking)
- Use over the counter mild pain relievers
- Keep the air around you free of irritants such as chemicals or cigarette smoke in the air
- Rest your body and your voice
- Gargle with a saltwater mix of ⅛ teaspoon per four ounces of water and spit
- Use a humidifier
- Sit in a steamy shower
If your symptoms are not getting better or you find yourself getting worse it is important to seek the advice of a healthcare professional.
Prevention of Viral and Bacterial Throat Infections
Getting sick is never fun. While many falsely believe that we are sick more often in the winter seasons because of the temperature, it actually has more to do with our tendencies to remain indoors.
Exposure to cold weather does not cause us to catch an infection, touching areas contaminated with respiratory droplets does. Touching a compromised surface and then touching your face is one of the easiest ways to become infected. The best steps to take to safeguard your health against viruses are:
- Wash your hands regularly and especially before eating
- Eat a diet high in fruits and vegetables
- Get enough rest
- If you are sick-stay home
- Avoid touching your eyes, nose and mouth
- Take a daily multivitamin
- Use alcohol hand sanitizer only if no soap and water is available.
Put the Power of a Physician in your Pocket
There is no reason to guess or search online when it comes to questions about your health. At Your Doctors Online we offer free online consultations. That means your important healthcare questions don’t have to wait-you can get your questions answered 24 hours a day, seven days a week.
So skip the waiting room by downloading our free app today.
Disclaimer: This article provides general information and is not intended to diagnose, treat or cure any disease or medical condition. If you require specific advice, please consult one of our medical professionals through the app. However, in case of an emergency, please call 911.
About Richard Honaker M.D.
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