Sore throat and fever are typical symptoms of angina, acute respiratory viral infections, diseases of the ENT organs, characterized by an acute course. However, there are pathological processes that are characterized by the fact that the throat hurts for a long time without temperature. They can be caused both by diseases of the throat and by pathological processes occurring in other organs and systems. If there is no temperature during an infectious or inflammatory process, this indicates that a sluggish process is developing in the body.
With such a development of the situation, the impact of pathogenic microorganisms is expressed insignificantly. Consequently, the body does not need to activate defense mechanisms and trigger a temperature reaction.
The absence of hyperthermia also indicates a reduced immunity, which may be due to congenital features or the presence of concomitant pathology.
If your throat hurts for more than a month without fever, this is a reason to consult an otolaryngologist and find out the cause of this condition.
Diseases of the ENT organs
Most often, such symptoms are accompanied by chronic diseases of the ENT organs in remission:
- tonsillitis;
- laryngitis;
- pharyngitis.
The chronic course of these diseases suggests that their duration exceeds 3 weeks. In their course, they are characterized by periods of exacerbation and remission. Most often, an exacerbation is noted in the autumn-winter period and is caused by hypothermia. However, there are other reasons for the development of these states. The provoking factors are
- dry air, the presence of dangerous chemical impurities, smoke;
- exposure to pathogenic microorganisms, bacteria, viruses;
- the presence of concomitant pathology, which has a depressing effect on the patient's immunity;
- traumatic effect of irritating substances (spicy food, hot meals);
- incorrect use of medical instruments during esophagoscopy, bronchoscopy.
Due to the influence of these factors, the patient may develop one or another pathology of the ENT organs, accompanied by a pain syndrome in the throat.
To normalize the condition of the mucous membranes, the air in the room must be cool and humid. Dry mucous membranes lead to the formation of a viscous secretion in the nasal cavity and throat. In addition, such conditions promote infection with pathogenic bacteria and viruses.
It is dry air that predisposes to the penetration and spread of pathogenic agents in the body.
The combined effect of unfavorable factors leads to an exacerbation of chronic diseases of the ENT organs. In this case, most often, an exacerbation is accompanied by an increase in body temperature.
If there is no temperature, this may be due to the following concomitant pathology:
- endocrine system diseases, hypothyroidism, diabetes mellitus;
- oncological diseases;
- HIV pathology;
- long-term use of antibiotics, corticosteroids, chemotherapy drugs.
In a state of remission, the disease usually proceeds at normal temperature, in rare cases, it may increase to 37.3 degrees in the evening.
The inflammatory process with pharyngitis and laryngitis is most often accompanied by the patient's complaints of perspiration, sore throat. During the day, the presence of such a symptom is constant, independent of the swallowing process. Such patients are necessarily worried about a dry, paroxysmal cough.
Laryngitis, which occurs with damage to the vocal cords, is also characterized by such a constant symptom as hoarseness. With an exacerbation of the process, sound reproduction may be accompanied by an increase in soreness in the throat. In such cases, patients prefer to spend most of their time in silence. The otolaryngologist who will conduct a pharyngoscopy will be able to clarify the localization of the lesion in the presence of a sore throat.
In chronic tonsillitis, the nature of the pain is somewhat different. In this case, patients do not complain of sore throat and other discomfort in the throat. They are worried about the pain that gets worse when swallowing. An objective examination of the throat cavity allows one to detect enlarged tonsils, in the crypts of which a dirty gray plaque with an unpleasant odor is noted.
The diagnosis is also confirmed by the detection of enlarged regional lymph nodes that are sensitive to palpation. Depending on the form of chronic tonsillitis, additional symptoms may occur, such as fatigue, interruptions in the heart area, and joint pain. Changes in laboratory tests are most typical during an exacerbation. However, remission is also characterized by leukocytosis, increased ESR, and impaired protein metabolism.
Finding out the causes of prolonged sore throat, it is necessary to remember about a possible tumor process occurring in the pharynx, larynx or thyroid gland. Patients describe the sensation in the throat as a feeling of a foreign body or a lump.
The first sign indicating the defeat of the larynx is a change in the timbre of the voice, its hoarseness, rudeness.
If the anti-inflammatory treatment carried out does not give results, it is necessary to conduct a close study of this pathology using hardware methods and laboratory diagnostics.
Infectious diseases
With the phenomena of prolonged tonsillitis, a disease of a viral nature, infectious mononucleosis, also proceeds. In some cases, complaints of a sore throat are present for a week, in others, this symptom is noted for several months. Other additional signs, lymphadenopathy, enlargement of the liver and spleen, can also be present for a long time, regressing within six months. Depending on the severity of the disease, the severity of clinical signs, an increase in temperature can be observed throughout the entire period of treatment, or more often a sore throat is accompanied by normal temperature indicators.
In adults, the presence of such symptoms can also be due to sexually transmitted infections. The causative agents of syphilis, gonorrhea, chlamydia can cause the development of an inflammatory process in the mouth and throat, which is accompanied by pain and proceeds without temperature. Long-term presence of symptoms necessitates laboratory diagnostics, including blood tests and bacteriological examination of scrapings from the oral cavity and pharynx.
Another rare cause of the development of these symptoms is a tuberculous process localized in the throat. The pathological condition is often characterized by prolonged subfebrile condition in the range of 37.2-37.3 degrees. However, there are many cases of the development of the disease without an increase in temperature.
Diseases not related to ENT pathology
Pathological processes that can be characterized by prolonged sore throat without fever include the following diseases:
- reflux esophagitis;
- angina pectoris and myocardial infarction;
- endocrine system diseases;
- hypovitaminosis;
- anemia and other blood diseases;
- neuralgia and diseases of the spine;
- periodontitis, inflammation of the gums;
- AIDS.
The reverse throwing of the contents of the stomach into the esophagus is possible with various diseases of the gastrointestinal tract, gastritis, esophagitis, peptic ulcer disease, hernia of the esophageal opening of the diaphragm. In this case, the patient has additional complaints in the form of belching, heartburn, upset stools, periodic heaviness in the abdomen.
As for the sore throat, it is clearly associated with food intake, develops after a hearty dinner and can be aggravated if the patient takes a horizontal position of the body or engages in physical exercises, especially bending of the torso.
A sore throat can mask a pathology of the heart. Spasm of the coronary vessels is accompanied by the development of pain syndrome, which is often localized behind the sternum, but can be given to the arm, under the scapula, throat. When carrying out differential diagnostics of such a condition, it is necessary to pay attention to the fact that this symptom appears first against the background of physical activity. In this case, additional symptoms may be noted, indicating the development of heart failure, shortness of breath, cyanosis. In more severe cases, swelling in the legs.
Among endocrine pathologies, diabetes mellitus or hypothyroidism can be characterized by a sore throat. One of the first signs of high blood sugar levels is dry mouth and thirst. These symptoms can be aggravated by a sore throat. Similar symptoms are present in patients taking corticosteroids for a long time. The consequence of this is the development of Itsenko-Cushing's syndrome, manifested by hyperglycemia and other symptoms of impaired carbohydrate metabolism.
With hypothyroidism, patients often complain of a feeling of a lump in the throat, difficulty swallowing. The mucous membranes and skin are dry. There is swelling of the lips, tongue. In these conditions, even pharyngoscopy is complicated.
A sore throat can also be due to insufficient intake of vitamins in the body. The reason for this is both forced fasting caused by extreme circumstances and due to anorexia.
Lack of vitamin C in the body is accompanied by ulcerative necrotic lesions of the oral mucosa, throat and tonsils, as well as tooth mobility and loss.
Atrophy of the oral mucosa, burning in the tongue, weakness are characteristic of vitamin B12 deficiency, which can be observed with anemia, gastritis.
Deficiency of vitamin A is manifested by dryness and erosive damage to the mucous membranes.
Anemias caused by profuse menstruation, intestinal bleeding, are also accompanied by damage to the mucous membrane of the throat.
Even more pronounced changes are characterized by the development of a pathological process in the throat with leukemia.
As a result of a weakened immune system, this condition is prone to the development of secondary processes in the throat, candidal or bacterial stomatitis, as well as pharyngitis. The development of fungal infections is facilitated by long-term treatment with corticosteroid drugs, antibiotics, cytostatics. Most patients with AIDS develop mucosal candidiasis.
Glossopharyngeal neuralgia may manifest as severe pain. The disease is characterized by paroxysmal pain, which is one-sided. Its duration varies within a few minutes. Starting at the root of the tongue, the pain spreads to the tonsil, throat, ear. The attack ends with salivation. The process is characterized by periods of remission and exacerbation.
In some cases, the disease progresses with constant pain. It is amplified by a variety of factors. Even the process of swallowing can provoke it. Despite the fact that the prognosis of the disease is favorable, the treatment process can take 2-3 years.
Osteochondrosis of the cervical spine can also be accompanied by pain syndrome not only in the corresponding spine, but also in the throat. The condition worsens with sudden movements. There may be a crunch. Teething and periodontitis can also be characterized by a sore throat without fever.
The presence of this symptomatology indicates chronic processes in the body that need to be identified and treated. Therapeutic measures started earlier are much more effective. Neglected cases are less responsive to treatment.
