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.
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.
Medical Matters is for information purposes only. The answers provided by Dr Shepherd and the ME Association’s other expert advisers should not be construed as medical advice. We recommend that any information you deem relevant is discussed with your GP as soon as possible. It is important to obtain advice from a GP who is in charge of your clinical care, who knows you well, and who can consider other likely causes for symptoms. Seek personalised medical advice whenever a new symptom arises, or an existing symptom worsens. Don't assume that new or worsened symptoms are a result of having ME/CFS.