The main symptom of pharyngitis is a sore throat. In infectious pharyngitis, other symptoms vary depending on whether the infection is viral or bacterial (usually strep throat):

• Viral pharyngitis — Sore throat often occurs with the following symptoms: pain when swallowing; redness in the throat; runny nose; stuffy nose; cough; hoarseness; redness of the eyes; and, in children, diarrhea. In some cases, there can be a painful redness around the mouth or small painful sores on the lips and inside the mouth.
• Strep throat — With strep throat and other forms of bacterial pharyngitis, sore throat can be accompanied by any of the following symptoms: fever; pain when swallowing; a generally sick feeling (malaise); headache; redness and swelling in the throat; a coating on the tonsils or tongue; and swollen, tender lymph nodes (swollen glands) in the front of the neck. Children also can have nausea, vomiting and abdominal pain.

Because symptoms of viral and bacterial pharyngitis can overlap, it may be difficult for the doctor to distinguish between them based on symptoms alone. Generally, if you have a prominent cough and nasal symptoms you’re more likely to have viral pharyngitis than strep throat.

In addition to viral and bacterial pharyngitis, an infection with fungi (Candida or "yeast") sometimes can cause throat pain, difficulty swallowing and white patches inside the mouth. This throat infection, commonly called thrush, usually affects infants and people with weakened immune systems. It is relatively rare among healthy older children and adults.

A sore throat that lasts for more than a couple of weeks may be caused by acid reflux from the stomach, breathing through the mouth in a dry environment, postnasal drip or, rarely, a tumor.

Diagnosis

After reviewing your symptoms, the doctor will ask if you might recently have been exposed to someone with strep throat or any other infection involving the throat, nose or ears.

Your doctor will examine you, paying particular attention to your mouth, throat, nose, ears and the lymph nodes in your neck. If your doctor thinks you have strep throat, he or she may prescribe antibiotics without further testing. If there is some uncertainty, the doctor may want to do a strep test. A rapid strep test is done in your doctor's office, takes only a few minutes to do and detects 80% to 90% of all cases of strep throat. If this quick test is negative, but your doctor still believes you might have strep, your doctor will take a sample of your throat fluids for more intensive testing in a laboratory. Results will be available in 24 to 48 hours.