Differential Diagnosis for Sore Throat
- Single Most Likely Diagnosis
- Viral pharyngitis: This is the most common cause of sore throat, often accompanied by other symptoms like cough, runny nose, and fever. It's 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, it presents with severe sore throat, fever, and swollen lymph nodes. A rapid strep test or throat culture can confirm the diagnosis.
- Tonsillitis: Inflammation of the tonsils, which can be caused by either viral or bacterial infections. Symptoms include sore throat, difficulty swallowing, and fever.
- Laryngitis: Inflammation of the larynx (voice box), often resulting from viral infections, overuse of the voice, or irritation from acid reflux. It typically presents with hoarseness, sore throat, and cough.
- Do Not Miss Diagnoses
- Epiglottitis: A potentially life-threatening condition where the epiglottis becomes inflamed, which can lead to airway obstruction. It's more common in children but can occur in adults, especially those with compromised immune systems.
- Peritonsillar abscess: A collection of pus behind the tonsils that can cause severe sore throat, difficulty swallowing, fever, and a muffled voice. It requires prompt medical attention, including antibiotics and possibly drainage of the abscess.
- Lemierre's syndrome: A rare but serious condition characterized by a bacterial infection of the tonsils, followed by the spread of the infection to the jugular vein, leading to thrombophlebitis. It can present with sore throat, fever, and neck pain.
- Rare Diagnoses
- Diphtheria: A bacterial infection caused by Corynebacterium diphtheriae, characterized by a sore throat and a greyish membrane covering the tonsils and throat. It's rare in areas with high vaccination coverage but can be deadly if not treated promptly.
- Infectious mononucleosis (Mono): Caused by the Epstein-Barr virus, it can present with sore throat, fever, swollen lymph nodes, and fatigue. While not typically life-threatening, it can lead to complications like splenic rupture if not properly managed.
- Gonococcal pharyngitis: A sexually transmitted infection caused by Neisseria gonorrhoeae, which can result in sore throat, often without other symptoms. It's essential to consider this diagnosis in individuals with a history of unprotected sexual contact.