Can Varicella Cause Sore Throat?
Yes, varicella (chickenpox) can cause sore throat, particularly in adult patients where it is one of the most remarkable symptoms and a main reason for hospitalization. 1
Clinical Presentation in Different Age Groups
Adults
- Sore throat is a prominent feature of varicella in adults, along with high fever, and these two symptoms are the primary reasons for hospitalization in most adult patients. 1
- Adult patients with varicella experience significantly more severe symptoms compared to children, with sore throat being notably more common and severe. 1
- The severity of sore throat in adults can be substantial enough to warrant supportive care and hospitalization in the early stages of disease. 1
Pediatric Patients
- The available guideline evidence does not specifically list sore throat as a characteristic feature of varicella in children. 2
- Varicella in children typically presents with fever, characteristic vesicular rash, and constitutional symptoms, but sore throat is not emphasized as a primary symptom in pediatric populations. 3, 4, 5
- The classic pediatric presentation focuses on the vesicular rash, fever of varying degree (101°F to 104°F), and in some cases headache, abdominal pain, nausea, and vomiting. 6
Important Clinical Distinction
It is critical to differentiate varicella from group A streptococcal pharyngitis, which commonly presents with sore throat as a primary symptom. 2
- Group A streptococcal pharyngitis presents with sudden-onset sore throat, pain on swallowing, fever, tonsillopharyngeal erythema with or without exudates, and anterior cervical lymphadenitis. 2
- If a child presents with prominent sore throat, consider viral pharyngitis or streptococcal infection rather than assuming it is part of varicella presentation. 2
Clinical Implications
- In pediatric patients with varicella, if sore throat is a prominent complaint, maintain vigilance for secondary bacterial infections, particularly invasive group A streptococcal disease, which is the most common serious complication requiring hospitalization. 3, 5
- Monitor for signs of bacterial superinfection including expanding erythema around lesions, purulent drainage, increasing pain or tenderness, and systemic toxicity. 3, 5