sore throat differential diagnosis

While a sore throat is one of the most prevalent illnesses seen in outpatient clinical practice settings, its origin can be attributable to a variety of viral and non-infectious causes, necessitating a differential diagnosis. Taking a history can be used to confirm the condition, but the emphasis should be on examining the manifestation. This stage should include documenting the length of the symptoms as well as confirming the occurrence of lockjaw. The examination should also inquire about self-medication and the severity of symptoms as defined by the existence of a rash, comparable developments in the past, swallowing difficulties, and hoarseness. Obtaining the history as well as possible risk factors is one of the most critical stages, as they can be used to establish connections to allergic reactions, gastroesophageal reflux disease, and acute thyroiditis (Charlett, & Coatesworth, 2007). The presentation is an indicator of the nature of a sore throat. When associated with a headache, cough, fever, and rhinitis, the condition is usually infectious. While it relies on the experience of the practitioner, symptoms can also lead to specific causes. Hoarseness also establishes laryngeal involvement. A persistent sore throat and recurrence of lymphadenopathy confirm glandular fever. Identification of a punctate skin eruption, a strawberry tongue, and a flushed face confirms streptococcal infection.

Another differential diagnosis is a physical examination. One of the commonly used tools is tongue depressor. If the test also shows stridor, drooling, and fever, they suggest bacterial infections. Pharyngeal redness as well as enlarged lymph glands are classic symptoms for bacterial and viral causes and help in ruling out non-infectious causes. Bacterial and viral causes are also distinguished through the Centor Criteria, a physical examination approach that relies on history with fever, tonsillar exudate, coughing, and tenderness of anterior cervical lymph nodes.

A CT scan among other imaging techniques is also a possible differential diagnosis, as it helps establish the connection of the symptom with other clinical conditions. The approach is preferred in patients with fast-developing infections, where life-threatening diseases such as GABHS pharyngitis could be underlying. Similarly, images also find enormous applicability in diagnosing atypical causes such as peritonsillar abscess (Li, Grubb, Panda, & Jones, 2009).


Charlett, S. D., & Coatesworth, A. P. (2007). Referred otalgia: A structured approach to diagnosis and treatment. International Journal of Clinical Practice, 61(6), 1015-1021.

Li, H. Y., Grubb, M., Panda, M., & Jones, R. (2009). A sore throat – potentially life-threatening? Journal of General Internal Medicine, 24(7), 872-875.

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