Does the patient need hospitalisation?
Most patients with sore throat can be safely managed in the community. However, patients with airway obstruction or a deep neck space infection require urgent transfer to hospital and airway management. Clinical features suggestive of airway obstruction or deep neck space infection are given in Clinical features associated with airway obstruction or deep neck space infection, and associated conditions are listed in Conditions associated with airway obstruction or deep neck space infection.
Patients with dysphagia causing dehydration or severe throat pain may also require hospital assessment or admission.
Follow hospital protocols for management, and see relevant sections in Therapeutic Guidelines.
- muffled voice
- stertor (snoring-type sound)
- stridor
- trismus
- drooling
- neck swelling
- torticollis
- severe neck pain
- unilateral throat pain
- respiratory distress
- signs of sepsis or septic shock (see Early recognition of sepsis or septic shock in adults or Early recognition of sepsis or septic shock in neonates, infants and children for definitions).
- acute epiglottitis
- peritonsillar abscess and peritonsillar cellulitis
- retropharyngeal abscess
- parapharyngeal abscess
- pharyngeal diphtheria
- severe Epstein–Barr virus (EBV) infection
- severe croup or bacterial tracheitis
- spreading odontogenic infections (including Ludwig angina)
- septic jugular thrombophlebitis (Lemierre syndrome).