What do you do if you or your child gets a sore throat during the COVID-19 pandemic?

Don’t delay treatment! Dr. Armstrong at Richmond ENT explains the common causes and treatment options.

Sore throats are common, but if you have a severe sore throat or a sore throat with a fever, you might need prompt medical attention.

What are the causes of a sore throat?


  • Strep throat
  • Common cold
  • Mononucleosis
  • Candida (thrush)
  • Peritonsillar abscess
  • Acute epiglottitis
  • Chickenpox
  • COVID-19
  • Influenza
  • Measles
  • HIV


  • Cancer
  • Acid reflux
  • Voice abuse
  • Angioedema
  • Allergies
  • Tobacco
  • Pollution
  • Dry air

Consult your doctor if you have any of the following warning signs:

  • Fever
  • Drooling
  • Bleeding
  • Severe pain
  • One-sided pain
  • Change in voice
  • Difficulty breathing
  • Difficulty swallowing
  • Lasts more than 2 weeks

Evaluation and Treatment

Your physician can often make the diagnosis on physical examination alone. Useful tests may include a throat swab for group A Streptococcus, COVID-19, or Influenza A/B. We use blood samples to test for mononucleosis and HIV. Some tests provide results in 5 minutes.

Viral sore throats are usually treated symptomatically with nonprescription pain medications.  We encourage you to drink plenty of fluids. Warm saltwater gargles and nonprescription throat lozenges may be soothing.

Strep throat and other causes of bacterial tonsillitis require antibiotic management – typically for 10 days. It is important to complete the antibiotic as prescribed, because undertreated Strep throat can cause permanent damage to the heart (rheumatic fever) and kidneys (acute glomerulonephritis). Recurrent or chronic tonsillitis may require a tonsillectomy.

Peritonsillar abscesses and epiglottitis are serious infections that can cause airway obstruction and death if not treated appropriately. Angioedema is a sudden onset of painful swelling that can involve any part of the mouth or throat. If you have any sudden swelling in the mouth or throat, especially if you have difficulty speaking or swallowing, go immediately to the nearest emergency department.

Cancers in the throat can become quite large before they cause pain. If you have any discomfort, swelling, bleeding or odor in the throat that persists longer than two weeks, please have your throat examined by an otolaryngologist.

Acid reflux is a common cause of a mild discomfort described as a “lump in the throat” or “postnasal drip.” A thorough examination by an otolaryngologist is recommended to exclude cancer before starting treatment. This examination might also include pH probe testing, or an examination of the throat and esophagus under anesthesia.

© 2020 Richmond ENT.  Written by Michael Armstrong MD and Michaela Bailey. Video produced by Michael Reymundi.