Acute Viral Pharyngitis (Sore Throat)

Two close up views of the throat showing normal tonsils and inflamed tonsils and throat.

You or your child have a sore throat (pharyngitis). This infection is caused by a virus. It can cause throat pain that is worse when swallowing, aching all over, headache, and fever. The infection may be spread by coughing, kissing, or touching others after touching your mouth or nose. Antibiotic medicines don't work against viruses. They are not used for treating this illness.

Home care

  • If symptoms are severe, you or your child should rest at home. Return to work or school when you, or your child, feel well enough. 

  • You or your child should drink plenty of fluids to prevent dehydration.

  • Adults, and children 5 years and older, can use throat lozenges or numbing throat sprays to help reduce pain. Gargling with warm salt water will also help reduce throat pain. Dissolve 1/2 teaspoon of salt in 1 glass of warm water. Children can sip on juice or an ice pop. Children 5 years and older can also suck on a lollipop or hard candy. (Hard candy and lozenges can be a choking hazard in children younger than 5 years.)

  • Don’t eat salty or spicy foods or give them to your child. These can be irritating to the throat.

Medicines for a child: You can give your child acetaminophen for fever, fussiness, or discomfort. In babies over 6 months of age, you may use ibuprofen as well as acetaminophen. If your child has chronic liver or kidney disease or ever had a stomach ulcer or gastrointestinal bleeding, talk with your child’s healthcare provider before giving these medicines. Aspirin should never be used by any child under 18 years of age who has a fever. It may cause severe liver damage and death. Don't give your child any other medicine without first asking your child's healthcare provider, especially the first time.

Medicines for an adult: You may use acetaminophen, naproxen, or ibuprofen to control pain or fever, unless another medicine was prescribed for this. If you have chronic liver or kidney disease or ever had a stomach ulcer or gastrointestinal bleeding, talk with your healthcare provider before using these medicines.

Follow-up care

Follow up with a healthcare provider or as advised if you or your child are not getting better over the next week.

When to get medical advice

Call your healthcare provider right away if any of these occur:

  • Fever (see Fever and children, below) 

  • New or worsening ear pain, sinus pain, or headache

  • Painful lumps in the back of neck

  • Stiff neck

  • Lymph nodes are getting larger

  • Can’t open mouth wide due to throat pain

  • New rash

  • Other symptoms are getting worse

Call 911

Call 911 or get medical care right away if any of these occur:

  • Trouble breathing or noisy breathing

  • Muffled voice

  • Can't swallow liquids, a lot of drooling, or any other symptoms that may mean worsening swelling in the throat

  • Signs of dehydration such as very dark urine or no urine, sunken eyes, dizziness

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4 or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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