Evaluation of Sore Throat Evaluation. Not every sore throat necessitates medical attention right away. The following information can assist people in determining whether or whether a doctor’s evaluation is required, as well as what to expect during the evaluation.
Warning Signs
Certain signs and characteristics in people with a sore throat should be taken seriously. They include the following:
- When breathing in, there is a squeaking sound (stridor)
- Any evidence of breathing trouble, specifically the tripod position, in which youngsters sit straight, leaning forward, neck inclined back, and jaw forced forward.
- Drooling
- “Hot potato” voice, muffled (speaking as if a hot object is being held in the mouth)
- The rear of the throat has a visible protrusion.
When should you see a doctor?
Those who exhibit warning signals should seek medical attention as soon as possible.
Call your doctor if you have a sore throat but no other symptoms. People with typical cold symptoms and mild to moderate discomfort should stay at home and manage their symptoms with over-the-counter (OTC) medications. Severe pain and/or other symptoms (such as fever, intense exhaustion, or productive cough) should be examined as soon as possible.
What does the physician do?
Doctors do a physical examination after asking questions about the patient’s symptoms and medical history. What doctors discover during the history and physical examination aids them in determining which tests, if any, are required (see table Some Causes and Features of Sore Throat).
Doctors inquire about the following throughout the medical history:
- A runny nose, cough, and trouble eating speaking, or breathing are all symptoms of a cold.
- If the person had a general feeling of extreme exhaustion prior to the sore throat (suggests mononucleosis)
- Whether the person has had a previous mononucleosis episode (people rarely get mononucleosis twice)
- Whether or not persons have gonorrhea risk factors (such as recent oral-genital sexual contact) or HIV infection (such as unprotected sex, multiple sex partners, or intravenous drug abuse)
Doctors concentrate on the nose and throat during the physical examination. Doctors do not examine the throat in their office if they suspect epiglottitis in youngsters (since there are warning signals and no evidence of a cold), because inserting a tongue depressor can produce a spasm that causes full airway blockage.
Doctors do the following tests if epiglottitis is not suspected:
- Look in the mouth to examine whether the throat and/or tonsils are red if the tonsils have white spots (exudate), and if there are any bulges that could indicate an abscess.
- Look for swollen, painful lymph nodes in the neck.
- Look for an enlarged spleen in the abdomen.
Testing of Sore Throat
The need for tests is determined by what doctors discover during the history and physical examination, particularly whether there are any warning signals. The following are some examples of possible tests.
- Rapid strep screening (for children)
- Throat culture (for adults)
- Flexible fiberoptic laryngoscopy
- X-rays of the neck
The first priority for a clinician is to determine who is at risk for epiglottitis. Drooling and stridor are warning indications, especially in those who appear unwell or have trouble breathing. In such instances, x-rays should be avoided. Instead, the doctor uses a small, flexible viewing tube put via the nose to peer down the throat (flexible fiberoptic laryngoscopy). Because children are more likely to have a total blockage of their airway when their throat is inspected, doctors limit this risk by performing the examination exclusively in the operating room, which has advanced airway equipment and specialists. Adults who do not appear to be very unwell and have no respiratory symptoms may have neck x-rays taken to check for a large epiglottis or a flexible fiberoptic laryngoscopy performed in the emergency room or at a specialist’s office.
Despite popular belief, doctors find it difficult to identify strep throat from a viral sore throat based just on looks. Both of these conditions might result in a highly red throat with white spots. Doctors frequently perform tests to detect strep throat unless people definitely have a cold. A quick strep antigen test and a throat culture are the two types of tests available. Both tests use a swab to collect a sample from the back of the neck. The fast strep antigen test takes about 20 minutes to do in the doctor’s office. Only children are subjected to quick test. If the results are positive, the youngsters are given medication to treat strep throat. If the results are negative, another sample is submitted to the lab, where bacteria are cultured and grown on a specific gel until there are enough to identify.
During a doctor’s examination, an abscess is frequently visible. After spraying the throat with an anesthetic, the doctor can identify and treat the abscess by inserting a small needle into the swollen area. If pus appears, an abscess has been verified, and the doctor will drain as much pus as possible. Doctors use a computed tomography (CT) scan of the neck to determine the location and size of an abscess.
Blood testing for mononucleosis or HIV is only performed when doctors suspect a patient has one of these illnesses.
Sore Throat Treatment
Doctors treat any underlying or specific problems. Antibiotics are administered to persons who have strep throat or other bacterial infections, for example.
It is critical to alleviate sore throat pain so that patients can eat and drink. Ibuprofen or acetaminophen are pain relievers and fever reducers. Short-term opioid use may be necessary for people in extreme pain (such as oxycodone or hydrocodone). Warm salt water gargles, throat lozenges, or throat sprays (including benzocaine, lidocaine, or dyclonine) may help reduce pain momentarily. When swallowing is uncomfortable and the child’s appetite hasn’t returned, soup is a fantastic approach to keep them hydrated and nourished.
