Fever, Hives and Sore Throat: What to Know

A viral illness can cause fever and throat irritation, while a widespread rash may appear as part of the immune response. Examples include a common cold, influenza, COVID-19 or glandular fever; tonsillitis can also cause a painful throat and fever.

Strep throat is a bacterial throat infection that may bring fever, throat pain and swollen neck glands. Hives are raised, itchy patches that can move around the skin. They may follow an infection, a medicine or a food exposure, and their presence does not by itself identify the cause of the sore throat.

Acid reflux and allergic rhinitis can irritate the throat, but fever and hives make an infection, medication reaction or another immune trigger more relevant. A clinician may need to examine the throat and skin and review recent medicines, foods and contacts.

Rest, drink fluids in small frequent amounts and choose soft foods or warm drinks if swallowing is uncomfortable. Keep a note of the temperature, when the hives began, any new medicine or food, and whether the rash fades when pressed.

Avoid starting leftover antibiotics or taking a suspected trigger again. If a clinician or pharmacist has previously advised an antihistamine for your hives, follow that advice and the product directions. Arrange medical advice promptly if the fever persists, the throat pain is worsening, the rash keeps returning or you feel increasingly unwell.

Call emergency services immediately for swelling of the lips, tongue or throat; trouble breathing, speaking or swallowing; faintness; confusion; or rapidly worsening hives. These can signal a serious allergic reaction or another emergency.

Seek same-day medical assessment for severe throat pain, drooling, inability to drink, marked one-sided throat swelling, a stiff neck, severe weakness, or a rash that is painful, blistering, purple or does not fade with pressure. Children, older adults, pregnant people and anyone with a weakened immune system should seek advice earlier when fever and a new rash occur together.

Ask: Could this be a viral illness, strep throat, tonsillitis or a reaction to something I took or ate? Do I need a throat test or other examination? Which symptom-relief medicines are suitable for me, and what warning signs should prompt urgent help?