Question

Like many people with ME I have more than my fair share of sore throats – sometimes accompanied by enlarged neck glands. I’ve read the MEA guidance on the self-help management of sore throats and I know that there’s usually no point in going to the doctor to ask for antibiotics. But having had a really nasty attack this winter, which did result in my GP prescribing a course of antibiotics, it would be helpful if you could clarify when we do need to consult a doctor.

Answer

Sore throats and tender glands are quite common symptoms in ME/CFS and form part of the symptom list in most of the criteria that doctors use to make a diagnosis. They are normally caused by viral infections, are short lived, and respond to simple self-help measures such as hot drinks with glycerine, honey and lemon and blackcurrent throat pastilles. But sore throats can occasionally have a more serious cause and may even require urgent medical attention.

Doctors have a ‘red flag’ list of symptoms and signs that suggest or indicate a more serious cause:

• Persistent sore throat for over six weeks,
• Excessive drooling,
• Lockjaw/decreased jaw opening (trismus),
• One-sided facial swelling,
• Problems with swallowing (dysphagia),
• Shortness of breath (dyspnoea),
• Taking a drug that suppresses the body’s immune system,
• Persistent one sided tonsillar enlargement,
• Neck stiffness and dislike of bright light/photophobia – suggesting meningitis,
• Non-blanching skin rash.

If any of the above features are present, you must speak with your GP. It’s also worth checking with your GP or pharmacist if you have a high temperature or feel generally unwell with a sore throat or if the sore throat persists for longer than a few days despite the self-help measures I have mentioned above.

More information

• The NHS: Sore Throat: Symptoms, Causes, Treatments | February 2021
• The ME Association has a range of detailed information about ME/CFS written by Dr Shepherd and other topic experts which can be downloaded from the website Free Literature, covering:
  • Symptoms,
  • Diagnosis,
  • Management.