Inflammations in the Upper Respiratory Tract

Two common conditions of the upper respiratory tract include laryngitis, an inflammation of the larynx (voice box), and pharyngitis, an inflammation of the pharynx (throat).

The larynx, or area of cartilage and tissue located at the entrance to the trachea, contains the vocal cords. When the larynx and vocal cords are swollen and inflamed, the result is usually hoarseness or loss of voice. Laryngitis that develops over a short period of time is typically caused by a viral infection, but it can be part of a bacterial infection. In most cases, laryngitis is not a serious condition, but it can be a nuisance. Chronic hoarseness (lasting longer than two weeks) should be followed up by a doctor’s visit to determine the cause and begin treatment.

Pharyngitis also can be viral or bacterial. A common cause of bacterial sore throat is group A Streptococcus, or strep throat. Nearly all sore throats that begin abruptly are caused by a virus and will disappear on their own without treatment. If a sore throat persists for more than several days, a doctor should be consulted to find out if it has a treatable cause. Streptococcal pharyngitis should be diagnosed and treated quickly to avoid long-term and serious complications, such as rheumatic fever or kidney failure. Sore throats due to a virus can be soothed with saltwater gargles, lozenges, fluids, and increased humidity in the air.

What Causes Loss of Voice and Sore Throat


Laryngitis can result from overuse of the voice, irritation from allergies or other environmental irritants, stomach acid reflux, or a viral or bacterial infection. In most cases, laryngitis is due to an infection from a virus, or less often, bacteria.

People at greatest risk for developing laryngitis are those with an upper respiratory infection. The symptoms of hoarseness or loss of voice develop over a short period and may be accompanied by swollen neck glands, sore throat, or fever. In some mild infections, the only symptom is hoarseness. In young children, two possibly severe causes of laryngitis are croup and epiglottitis. Croup can follow a cold and results in a barking cough and difficulty breathing at night. Epiglottitis is a relatively rare, but life-threatening, complication of a bacterial infection that causes the airways to close due to rapid swelling of the larynx and surrounding tissues.

If laryngitis is a chronic problem, the doctor will investigate the possible causes for the swelling and inflammation. If laryngitis is not due to an infection, it is most often a result of injuring the vocal cords through overuse, smoking, or stomach acid reflux. Hoarseness can also be a result of growths or other abnormalities of the vocal cords. A specialist of the ear, nose, and throat can perform tests on the vocal cords to determine the cause of the hoarseness and the appropriate treatment.

For most cases of laryngitis, treatment consists of resting the voice box (not talking). Keeping the throat moist and the air humidified can be helpful. It is best not to whisper or clear the throat continually, since these actions actually strain the vocal cords. If the laryngitis is due to a bacterial infection, it should be treated with antibiotic therapy. If a young child has a fever and laryngitis with difficulty breathing and is drooling, a doctor should be consulted immediately.


Pharyngitis, or sore throat, accounts for over 18 million visits to the doctor each year in this country. About 90% of these cases are caused by such viruses as the cold or flu or Epstein-Barr, the cause of mononucleosis. There are several bacterial causes of sore throat, and if left untreated, bacterial pharyngitis can lead to complications. The most common bacterial cause of pharyngitis is group A streptococcus, or strep throat. Children and teenagers are most often affected by sore throats. The diagnosis of pharyngitis is made during a thorough physical exam which focuses on the throat and lymph nodes. Since the cause of pharyngitis cannot be determined by simply looking at the throat, a quick screening test or a culture can be taken to look for streptococcus or mononucleosis.

Treatment for viral pharyngitis is similar to that for viral laryngitis: Saltwater gargles, lozenges, fluids, and increased humidity in the home are recommended. If a sore throat continues for more than several days, a doctor should be consulted. If an antibiotic is prescribed, it is important to finish the entire prescription as directed to guarantee success and avoid complications.

Since the viruses that cause laryngitis and pharyngitis can be easily spread by direct contact, coughing, or sneezing, hand washing is the first and best defense against their spread. Regular hand washing with soap throughout the day is the best prevention of these wintertime diseases. If soap and water are not available, alcohol-based hand sanitizers with moisturizers are effective alternatives.

Your pharmacist can help you select over-the-counter medications to relieve symptoms of pharyngitis or laryngitis and answer questions about antibiotics if they are prescribed for the treatment of these conditions.