What is Cobblestone Throat (Pharyngitis)? 

Published April 25th, 2022 by Corey Riley
Fact Checked by
Erik Rivera
Medically Reviewed:
Dr. Angel Rivera
Updated Date: Jun 22nd, 2022

Cobblestone throat is the colloquial name for pharyngitis or acute pharyngitis and it is a condition that can cause a lot of pain and discomfort in your throat.

It may also be accompanied by other symptoms such as a fever, swollen lymph nodes in the neck or throat, and a general feeling of being unwell.

It is very treatable though, and we will detail your treatment options below.

In this article, we will also cover the symptoms, causes, and other complications that can happen due to pharyngitis.

What is Cobblestone Throat (pharyngitis)?

Pharyngitis is a condition that results in the formation of small, raised bumps on the back of the throat, which is also known as the pharynx, and can make swallowing difficult and cause pain and discomfort.

The bumps are actually inflamed tissue due to extra mucus in your throat.

The condition is most commonly seen in children, but adults can also be affected.

The reason it is called cobblestone throat is that the bumps resemble cobblestones.

Please note that even though there may be bumps in your throat that the bumps are not cancerous and can not become cancerous.

cobblestone throat image

What are the symptoms of pharyngitis?

The bumps in the back of your throat are not the only symptoms of pharyngitis, other symptoms of pharyngitis include:

  • Sore throat
  • Pain with swallowing or talking
  • Redness or an irritated throat
  • Swollen lymph nodes, also called lymph glands, in the neck, throat, or tonsils
  • Hoarse voice
  • White or grey spots in the back of the throat which are actually pus packets
  • Coughing, especially a dry cough
  • Nausea
  • Bad breath, also called halitosis
  • Feeling the need to clear your throat
  • Congestion
  • Fever

The bumps can also make your throat feel scratchy or have throat tightness and it may feel like something is caught in your throat which may cause you to perform constant throat clearing.

If you or a loved one have these symptoms of pharyngitis please see your doctor or health care provider.

What causes pharyngitis?

The bumps in your throat are caused by an overproduction of mucus. The overproduction of mucus can be due to:

Postnasal drip

Postnasal drip is when your nose is constantly running or dripping which can be for several reasons we will detail below.

The mucus drips down the back of your throat and causes irritation and inflammation, leading to pharyngitis.

Dry air

Dry air can also lead to an overproduction of mucus as your body tries to moisten the air you are breathing and this is especially true in the winter when the air is drier.

Allergies and irritants

Allergies can also cause postnasal drip as your body reacts to an irritant by producing more mucus to protect you.

Allergies can be caused by pollen, dust mites, animal dander, and more. Other irritants include smoke, dust, dirt, and air pollution among others.

Colds and flu

Colds and the flu are caused by viruses and your body produces mucus to protect you from the virus.

The mucus can also irritate your throat leading to pharyngitis.

Acid reflux

Acid reflux occurs when stomach acid flows back up into your esophagus and can cause heartburn, chest pain, and a sour taste in your mouth.

A specific type of acid reflux is called laryngopharyngeal reflux (LPR) and the acid can also irritate your throat leading to cobblestone throat.


Certain medications can also lead to an overproduction of mucus such as:

  • Antihistamines
  • Decongestants
  • Nasal sprays
  • Birth control pills

Viral infections

There are several viral infections besides the common cold and flu that can cause pharyngitis and they include:

  • Measles
  • Chickenpox
  • Mononucleosis, which is caused by the Epstein-Barr virus
  • Croup
  • Herpes simplex virus, which is oral herpes
  • Enteroviruses, which include hand, foot, and mouth disease

Bacterial infections

Strep throat, also called Streptococcal pharyngitis, is the most common cause of pharyngitis due to bacterial infections and can also lead to tonsilitis, with pharyngitis being the most common symptom of it.

However, there are several others that can cause pharyngitis and they include:

  • Neisseria gonorrhoeae, which causes gonorrhea
  • Pneumonia caused by the both the Chlamydia pneumoniae and the Mycoplasma pneumoniae bacterias


It is very common for the human immunodeficiency virus, also called HIV, to cause pharyngitis and other symptoms that are similar to mononucleosis.


Pregnancy can also lead to pharyngitis as the extra hormones produced during pregnancy can lead to postnasal drip.

Spicy foods

Eating spicy foods can also lead to pharyngitis as the spices can irritate your throat causing your body to make more mucus.

Object stuck in your nose

When an object gets stuck in your nose, which can often happen to children, it can cause an infection that leads to pharyngitis.

If you have pharyngitis it is important to see your doctor or health care provider as soon as possible. They will be able to properly diagnose and treat you.

How is pharyngitis throat diagnosed?

In order to properly diagnose pharyngitis, your doctor will start by taking a medical history and asking about your symptoms.

Your doctor will also ask about your recent exposures such as if you have been around someone who is sick, if you have traveled recently, or if you have started taking any new medications.

Your doctor will also do a physical examination which will include looking at your throat and feeling for any enlarged lymph nodes in your neck and also listen to your breathing through a stethoscope.

Your doctor may also take a swab of your throat, also called a throat culture, to test for strep throat.

How is pharyngitis treated?

The treatment for pharyngitis will depend on the cause. If you have a viral infection, such as the flu or a cold, there is no specific treatment although you can drink plenty of fluids, use over-the-counter medications that are painkillers for any pain, and use throat lozenges to soothe any throat irritation.

You can also use an anesthetic spray to help numb your throat too. If you have a bacterial infection such as strep throat, your doctor may prescribe antibiotic medications if the strep throat test is positive.

It is important that you take all of the medication even if you are feeling better as this will help prevent any complications.

Other treatments include switching medications if your medications are causing pharyngitis, removing an object from your nose, or taking medications for whatever may be causing it such as allergies.

Please talk to your doctor to determine the most effective treatment for you.

What are the complications of pharyngitis?

If pharyngitis is not properly treated and you have chronic pharyngitis, it can spread to adjacent areas of your body and cause problems such as sinus infections, ear infections, or pneumonia.

It is important to see your doctor or health care provider as soon as possible if you think you may have pharyngitis so that it can be properly diagnosed and treated.

How can I prevent pharyngitis?

There are several things that you can do to help prevent pharyngitis such as washing your hands often, avoiding close contact with people who are sick, and avoiding sharing cups or eating utensils with others.

You can also clean any surfaces that may be contaminated such as door handles, keyboards, or countertops.

If you have a cold or the flu, cover your mouth and nose when you sneeze or cough to help prevent the spread of germs.

You need to also stay home from work or school if you are sick to help prevent the spread of illness.

Finally, if you have a chronic condition such as allergies or asthma, make sure to take your medications as prescribed and see your doctor or health care provider regularly to help prevent any exacerbations.


Pharyngitis is a condition that can be caused by several things such as viral infections, bacterial infections, allergies, or irritants among others.

The symptoms of pharyngitis include sore throat, pain with swallowing, fever, and swollen glands but it is not limited to just these symptoms.

Pharyngitis can be diagnosed by your doctor at their office with a review of your medical history, physical examination, and sometimes a strep throat test.

Treatment for pharyngitis depends on the cause and ranges from treating cold and flu symptoms to taking antibiotics prescribed by your doctor.

Pharyngitis can lead to other problems such as sinus infections, ear infections, or pneumonia if it is not properly treated so it is important to see your doctor if you think you may have it.

If you have any more questions regarding pharyngitis or if you think you have it, please talk to your doctor or healthcare provider.

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