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Last updated: September 26, 2025View editorial policy

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Differential Diagnosis for Sore Throat and Low-Grade Fever

Single Most Likely Diagnosis

  • Viral Pharyngitis: This is the most common cause of sore throat and is often accompanied by a low-grade fever. It is usually self-limiting and caused by viruses such as rhinovirus, coronavirus, or adenovirus.

Other Likely Diagnoses

  • Streptococcal Pharyngitis (Strep Throat): Caused by Group A beta-hemolytic streptococcus, this condition presents with sore throat, fever, and can be differentiated from viral pharyngitis by a rapid strep test or throat culture.
  • Influenza: Especially during flu season, influenza can cause sore throat, fever, and other systemic symptoms like body aches and cough.
  • Mononucleosis (Mono): Caused by Epstein-Barr virus, mono can present with sore throat, fever, fatigue, and lymphadenopathy, especially in young adults.

Do Not Miss Diagnoses

  • Epiglottitis: A potentially life-threatening condition that can cause severe sore throat, difficulty swallowing, and high fever. It requires immediate medical attention.
  • Lemierre's Syndrome: A rare but serious condition that starts with pharyngitis and can progress to sepsis and jugular vein thrombosis, typically caused by Fusobacterium necrophorum.
  • Retropharyngeal Abscess: A collection of pus in the tissues in the back of the throat, which can cause severe throat pain, difficulty swallowing, and fever, and requires prompt medical intervention.

Rare Diagnoses

  • Diphtheria: A bacterial infection that can cause a sore throat and a membrane to form over the tonsils and throat, though it is rare in areas with high vaccination rates.
  • Tuberculosis (TB): Can cause chronic sore throat and fever among other symptoms, especially in immunocompromised individuals or those exposed to TB.
  • Syphilitic Pharyngitis: A manifestation of primary syphilis, which can cause a sore throat and other systemic symptoms, particularly in individuals with high-risk sexual behavior.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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