Springdale Mason Pediatrics

Sore Throat - Symptom

Definition

  • Pain, discomfort or raw feeling of the throat
  • Pain is made worse when swallows
  • The infection is in the throat and usually also involves the tonsils.
  • Children less than 2 years of age usually can't complain about a sore throat. A young child who does not want favorite foods may have a sore throat. They may also start to cry during feedings.

Call or Return If

  • Trouble breathing or drooling occurs
  • Sore throat is the main symptom and lasts more than 48 hours
  • Sore throat with a cold lasts more than 5 days
  • Fever lasts more than 3 days
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Causes

  • Usually caused by an infection of the throat (pharyngitis). Since the tonsils are in that area, they are usually also infected (tonsillitis).
  • Colds (URIs). Most sore throats are part of a cold. In fact, a sore throat may be the only symptom for the first 24 hours.
  • Influenza. A sore throat can be the first symptom in flu infections.
  • Viral pharyngitis. Some viruses cause a sore throat without nasal symptoms.
  • Herpangina. A special viral infection of the throat that causes little ulcers near the tonsils.
  • Strep pharyngitis. Group A Strep is the most common bacterial cause. It accounts for 20% of persistent sore throats. Only these need an antibiotic.
  • Postnasal drip. Drainage from sinus congestion can cause a sore throat. Sometimes, it's because the secretions are irritating to the throat. More often, it's from the frequent throat clearing.
  • Mouth breathing. Children who sleep with the mouth open may wake with a sore throat. It feels better within an hour of having something to drink. Use a humidifier to help prevent a dry mouth.

Strep Throat

  • Symptoms include sore throat, fever, headache, stomach pain, nausea and vomiting.
  • Cough, hoarseness, red eyes, and runny nose are usually not seen with Strep throat. These symptoms point more to a viral cause.
  • Scarlet fever rash (fine, red, sandpaper-like rash) is highly suggestive of Strep throat.
  • Peak age: 5 to 15 years old. Not common under 2 years old unless sibling has Strep.
  • Diagnosis should be confirmed by a Strep test before starting treatment. There is no risk to wait until a Strep test is done.
  • Standard treatment is with antibiotics by mouth.

Prevention of Spread to Others

  • Good hand washing can prevent spread of infection.

After Care Advice

Overview:
  • Most sore throats are just part of a cold and caused by a virus.
  • A cough, hoarse voice or nasal discharge points to a cold as the cause
  • If a sore throat is the only symptom, it's still usually viral. A fever or swollen neck lymph nodes point to this as the cause.
  • Here is some care advice that should help.
Sore Throat Pain Relief:
  • Age over 1 year. Can sip warm fluids such as warm chicken broth or apple juice. Some children prefer cold foods such as popsicles or ice cream.
  • Age over 6 years. Can also suck on hard candy or lollipops. Butterscotch seems to help.
  • Age over 8 years. Can also gargle. Use warm water with a little table salt added. A liquid antacid can be added instead of salt. Use Mylanta or the store brand. No prescription is needed.
  • Medicated throat sprays or lozenges are generally not helpful.
Pain Medicine:
  • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.
Fever:
  • For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. Note: Lower fevers are important for fighting infections.
  • For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.
Antibiotics Not Needed:
  • Antibiotics are not helpful for viral infections.
  • They can only kill bacteria.
Fluids and Soft Diet:
  • Try to get your child to drink adequate fluids.
  • Goal: Keep your child well hydrated.
  • Cold drinks, milk shakes, popsicles, slushes, and sherbet are good choices.
  • Solids. Offer a soft diet. Also avoid foods that need much chewing. Avoid citrus, salty, or spicy foods. Note: Fluid intake is much more important than eating any solids.
  • Swollen tonsils can make some solid foods hard to swallow. Cut food into smaller pieces.
What to Expect:
  • Most often, sore throats with a viral illness last 4 or 5 days.
Return to School:
  • Your child can return to school after the fever is gone.
  • Your child should feel well enough to join in normal activities.
  • Also, children with Strep throat need to be taking an antibiotic for 24 hours.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2020 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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