Herpes simplex virus (HSV) is known for causing cold sores and genital herpes. However, this common virus can also affect less typical areas, including the back of the throat. While often associated with visible external lesions, HSV in the throat can cause significant symptoms. This article explores how such an infection is recognized and managed.
Can Herpes Affect the Throat?
Herpes can affect the back of the throat, a condition known as herpetic pharyngitis. If it extends to the esophagus, it’s called herpes esophagitis. HSV-1, commonly linked to oral herpes, is the primary cause of throat infections, though HSV-2 can also be responsible, especially through oral sex. The virus spreads through direct contact with an infected person, often via mouth-to-mouth or oral-genital contact.
Once contracted, the herpes simplex virus establishes a lifelong presence, lying dormant within nerve cells. This means the virus can reactivate later, even after an initial infection clears, leading to recurrent outbreaks. When reactivated, it travels along nerve pathways to the throat, mouth, or esophagus, causing new lesions and symptoms.
Recognizing Symptoms
When herpes affects the throat, symptoms can sometimes be mistaken for other common throat infections. A prominent symptom is a severe sore throat, often accompanied by difficulty swallowing (dysphagia). Other general symptoms include fever, headache, and body aches. Swollen lymph nodes in the neck are also common.
A distinguishing characteristic of herpes in the throat is the appearance of small, painful blisters or ulcers. These lesions can develop on the tonsils, the back of the throat, or the roof of the mouth. While strep throat typically presents with red spots and white patches on the tonsils, herpes causes distinct blisters and sores. This visual difference, along with other symptoms, helps differentiate herpetic pharyngitis from other causes of throat discomfort.
Diagnosis and Management
Diagnosing herpes in the throat involves a physical examination by a healthcare professional, who assesses medical history and examines the throat for characteristic lesions. To confirm the diagnosis, laboratory tests may be performed. These include a viral culture, which tests a sample from sores for HSV, or a polymerase chain reaction (PCR) test, which detects the virus’s genetic material. Blood tests for antibodies can also determine if a person has been exposed to HSV, though these do not indicate an active infection. For suspected herpes esophagitis, an endoscopy might be performed.
While there is no cure for herpes, treatment focuses on managing symptoms and reducing the duration and severity of outbreaks. Antiviral medications like acyclovir, valacyclovir, and famciclovir are the main approach, inhibiting the virus’s ability to replicate to help sores heal faster and lessen discomfort. For optimal effectiveness, antiviral treatment is most beneficial when started within 48 hours of symptom onset. Supportive care, such as over-the-counter pain relievers, hydration, and soft foods, can also help alleviate symptoms. To reduce transmission risk, practicing safe sex and avoiding oral contact during active outbreaks are important preventative measures.