Sore
throat is one of the commonest of all ailments. It can vary
from the mild and transient, which it usually is, to the choking
agony of quinsy (tonsillar abscess). Sore throats are extremely
common amongst children of school age, or younger, if they are
at kindergarten, because, generally, the more exposure to other
children, the more sore throats. The acute sore throat, accompanied
by a fever, in a child of 6 years is quite likely to be tonsillitis.
This could be bacterial or viral, though the presence of white
spots on the tonsils makes it more likely bacterial, resulting
from a streptococcal infection. An acute sore throat, with white
exudate covering the tonsils, in a boy of 17 years, could still
be tonsillitis but, equally, it could be glandular fever, a
virus infection. The development of an acute sore throat in
an elderly person must be taken seriously, as there is always
the possibility of malignancy. Sore throat can be part of a
local process as in tonsillitis, or as a symptom of a general
illness, the sore throat or pharyngitis, for example, of coryza
(see Coryza) or influenza (se Influenza). Many general infections
can give a sore throat, as may some serious illnesses such as
blood disease. Toddlers tend not to complain of sore throat
and, if it is not looked for in the unwell child, it can be
missed. The two most severe infections giving a sore throat
are the quinsy, in which an abscess forms in and around the
tonsil, and epiglottitis, a potentially fatal infection, particularly
in children, though, happily, quite rare. In epiglottitis, the epiglottis (see Cough) can become swollen and lead to acute blockage of the airways. Chronic sore throat can result from mouth breathing, particularly at night, and is common in any situation where there is nasal blockage, as in hay fever (see Hay fever) and sinusitis (see Sinusitis)
The management of a simple sore throat is usually throat sweets, drinks and, perhaps, some mild painkillers. The treatment of throat infections by the doctor is somewhat more contentious. The majority of such are viral, but a substantial minority is caused by the haemolytic streptococcus, and it is arguable that this infection should be treated with penicillin. Unfortunately, there is usually no naked-eye way of telling the difference. The tendency, these days, is to give antibiotics far less often for sore throats than was done previously. The teenager with apparent tonsillitis should always have a blood test for glandular fever. Blood tests may also show other diseases of the blood which can produce a sore throat. If a quinsy is suspected the patient is generally referred to the hospital where the abscess may be drained. Epiglottitis, if suspected - and one of the early signs is the inability of the people to be able even to swallow their own saliva - is a medical emergency. If nasal blockage is suspected as a cause of the sore throat it should be treated appropriately - nasal sprays, decongestants etc. If tonsillar infection is frequent, not only in the child, in an adult it can be chronic and lowering, removal of the tonsils (tonsillectomy) should be considered. |
