Cold sore throat, and not only …

It almost always accompanies the runny nose, but it can also be due to bacterial infections or be the expression of an irritation.

Sometimes it is the first alarm bell of a cold that is about to arrive. And so at its origin there is an infection caused by one of the many cold viruses.

But it is not uncommon that to cause that annoying sensation of pins pointed at the throat are external agents, such as smoke or other irritants, or even for having spoken (or shouted) too much.

In addition, any bacterial infections (usually streptococcus) should not be overlooked, which in addition to the throat may also involve the tonsils.

To understand if the cause of the sore throat is viral or bacterial, your doctor may perform a streptococcal detection test.

However, there are some clues (explained later in detail) that help distinguish between a sore throat due to a cold (and therefore viral) and a bacterial one. Here, for example, are the typical symptoms in the first and second cases.

	Symptoms
Viral sore throat	Reddened or watery eyes Stuffy or runny nose Frequent coughing and sneezing Headache Fever
Bacterial sore throat	Strong and sudden sore throat Loss of appetite Swelling in the throat Reddened tonsils with white plaques Fever Headache

If the virus is to blame

Sore throat caused by a virus is usually accompanied by other cold symptoms, which may include:

• red or watery eyes
• stuffy or runny nose
• frequent coughing and sneezing
• headache
• fever.

Nonsteroidal anti-inflammatory drugs, such as acetylsalicylic acid, flurbiprofen or ibuprofen, can accelerate healing by acting on inflammation. It is also always good to get adequate rest, follow a healthy diet and drink plenty.

These drugs come in different forms such as sprays and tablets. To relieve symptoms, nasal decongestants are also useful to reduce irritation caused by runny nose. They should not be used for more than three consecutive days.

In these cases, antibiotics are not effective and, therefore, should not be used.

Sore throat and streptococcus

Symptoms are typically more severe than those of a cold, and may include:

• severe and sudden sore throat
• loss of appetite
• swelling in the throat
• reddened tonsils with white plaques
• fever
• headache.

Streptococcal infection is spread through direct contact with an infected person and/or by sharing personal items with them.

Although it is more common in children aged 5 to 13, it can also occur in adulthood.

If not properly treated, streptococcal infection can cause serious illnesses, such as rheumatic fever that can damage the valves of the heart.

That is why it is important to have adequate treatment with antibiotics that, in general, resolve the infection in about ten days.

The most commonly used are penicillin and amoxicillin. It is necessary to finish the therapy even if, in the five or ten days of treatment, you feel better. In fact, it is not uncommon for the symptoms to be drastically reduced or disappear within a day or two, but it is not said that the bacteria have been eradicated.

You should seek medical attention again if:

• fever persists after two days of treatment
• The fever reappears after it has subsided.

Or if they arise:

• nausea or vomiting
• Earache
• headache
• spots on the skin
• cough
• enlargement of the glands of the neck
• Shortness
• dark urine
• rash or pain in the chest.

What if it was tonsillitis?

Sometimes a sore throat is caused by a tonsillitis, an inflammation of the tonsils that can be viral or bacterial.

In these cases, in addition to throat irritation, the tonsils are swollen, may show telltale white or yellow plaques.

Other symptoms include:

• bad breath
• fever
• voice changes due to swelling
• swollen lymph glands of the neck.

If the tonsillitis is bacterial your doctor will prescribe antibiotics. If the infection is viral, antibiotics are not needed: the virus must run its course before the sore throat resolves.

In both cases, however, it is advisable to take the following measures that help healing:

• rest as much as possible
• drink plenty of water
• eat light and soft foods (such as ice cream, semifreddo desserts and soups)
• avoid crunchy or spicy foods
• Use a vaporizer to humidify the air.

Against pain can be useful analgesics such as paracetamol, or NSAIDs, such as acetylsalicylic acid, furbiprofen, ibuprofen that in addition to acting on pain help resolve inflammation.

If antibiotics don’t cure the bacterial infection, if tonsillitis recurs repeatedly, or if they interfere with sleep and breathing, your doctor may suggest surgical removal of the tonsils (tonsillectomy).