EAR, NOSE, THROAT, AND DENTAL DISORDERS - Medicine for Mountaineering and Other Wilderness Activities - page 209

Drying
Prolonged mouth breathing, particularly in hot, dry climates, or in cold climates at high
altitudes where air has a very low relative humidity when warmed to body temperature,
causes drying of the mouth and throat and can result in a sore throat. An irritating, dry,
hackingcoughisalsousuallypresent.Recognizingtheexistenceofconditionscausingdry-
ingofthethroatandexcludingthepresenceofotherdiseasescharacterized byasorethroat
can identify this condition. Drying of the throat is not accompanied by chills, fever, or en-
largement of the lymph nodes of the neck or under the jaw. The throat may be mildly in-
flamed (red) but exudates (white spots) are not present.
Treatmentofanykindisusuallydisappointing.Lozengescontaininganestheticsoranti-
biotics are available. However, hard candy or rock sugar melted in the mouth (not chewed)
isprobablyjustaseffective,ismuchlessexpensiveandeasiertoobtain,anddoesnotcarry
the dangers associated with indiscriminate antibiotic use. Lozenges should be taken only
abouteveryfourhours,butcandycanbeconsumed freely.Inaddition, thecandyhasnutri-
tionalvalue,whichisimportantathighaltitudeswherelossofappetitemakestheingestion
of any food a problem.
Viral Pharyngitis
In conditions that do not produce drying, viral infections are the most common cause of
sorethroats.Viralpharyngitis(viralsorethroat)commonlyaccompaniesacoldbutmaynot
beassociatedwithinfectionelsewhere.Thepersonusuallydoesnotfeelorappearseriously
ill, although a few individuals feel much worse than most others. Fever may be present but
is rarely higher than 101°F (38.5°C). The throat is inflamed, but exudates are not present
and enlargement of lymph nodes is rare.
Before accepting a diagnosis of viral pharyngitis, streptococcal pharyngitis must be
ruled out.
Viral sore throat usually clears up in three to six days without therapy. Lozenges may
provide some relief, but hard candies melted in the mouth are equally effective. Antibiot-
ics are of no benefit and should be avoided unless streptococcal infection is seriously sus-
pected. However, distinguishing between these two infections without laboratory facilities
may be impossible.
Streptococcal Pharyngitis
Streptococcal pharyngitis (strep throat) is encountered less frequently than other causes
ofsorethroatbutcanbetreatedmuchmoresatisfactorily.Thisinfectioniscausedbystrep-
tococci and is potentially dangerous because it can lead to rheumatic fever, which may
damage the heart valves.
Individuals with streptococcal pharyngitis typically feel and appear ill (malaise). Fever
is usually present and may reach 103°F (39.5°C) or higher. Chills often occur. The throat