Sore Throat (Children)

Why does my child have a sore throat?

In children, a sore throat is almost always due to an infection. A host of bacteria and viruses can cause this common condition, also known as pharyngitis. Irritants such as cigarette smoke can also cause a sore throat.

Is a sore throat ever serious?

Most sore throats are harmless. Swollen glands, ear infection, and congestion can accompany sore throat, but are rarely dangerous. If your child has a lot of pain and drooling and seems very ill, she might have a deep pocket of pus called an abscess, but this rarely happens.

Two common types of sore throats that can become serious are strep throat and mononucleosis. Strep throat must be treated promptly because in rare cases it can, if untreated, lead to rheumatic fever that might result in heart problems or other complications. Although there is no specific treatment for infectious mononucleosis, it is important to diagnose because it can cause enlargement of the spleen and liver.

Who is most likely to get sore throat?

Anyone can get a sore throat, but throat pain from mononucleosis most often affects adolescents, whereas strep is most common in school children. Strep throat is relatively rare in children under 3.

How can I tell the difference between a sore throat and strep throat?

Fifteen to 36 percent of sore throats are strep throat, which is caused by a streptococcal bacteria. Only a doctor can tell for certain that your child has strep throat. But if your youngster has typical cold symptoms, such as a cough or a runny nose, it's unlikely she has strep throat. Look inside your child's mouth: If she has extremely red, swollen tonsils streaked with white pus, there's a good chance she has strep. She may also have headaches, fever, or swollen, tender lymph nodes in her neck. In rare cases your child may get a fine, sandpaper-like rash all over her body: Strep throat accompanied by this rash is called scarlet fever.

Your doctor can usually diagnose strep right in the office by using a throat swab to do a rapid test for strep antigens. If the rapid test is positive, it means your child has strep throat. If it's negative, your doctor will send a second throat swab to a special lab for a culture. It takes a day or two to get the result, but the test is very accurate. If that test also comes out negative, your child doesn't have strep throat. Depending on the child's age and symptoms, your doctor may order more tests to check for such illnesses as mononucleosis.

If my child has strep, do I need to be treated?

Yes, if you develop symptoms of strep throat. Family members without symptoms don't have to be treated.

What are the treatment options for sore throat?

If your child has strep or scarlet fever, your doctor will put her on penicillin unless she's allergic to it. Some doctors give a single penicillin shot, although it's usually prescribed in pill or liquid form for ten days. If so, it's crucial that your child take all the medicine even if the symptoms get better. When a child has a penicillin allergy, erythromcycin may be used.

Strep accounts for only 15 percent to 36 percent of throat infections, however. Most are caused by viruses, which means that for the majority of sore throats, antibiotics not only are not necessary but will not work.

Most regular sore throats go away by themselves in two to four days, and simple home treatments usually work well. Have your child gargle with warm salt water, if she's old enough. Ease her throat pain with soothing beverages, warm or cold. Acetaminophen can help relieve the pain. (Never give aspirin to children or teenagers, though, because it could cause Reye's syndrome, a rare but potentially life-threatening condition.)

When should I call the doctor?

Call 911 or go to an emergency facility immediately:

  • If your child can't swallow liquids or has trouble breathing

If any of these conditions is present, call for an immediate appointment:

  • Your child's tonsils are red and have spots or streaks of white pus on them
  • She has a fever over 101 degrees
  • The sore throat outlasts her cold, which typically spans five to seven days
  • The glands near your child's jawbone are swollen and it hurts to swallow

How can I prevent sore throats?

  • Keep your child away from cigarette smoke. If you smoke, quit.
  • Don't expose her to people who have strep throat or a sore throat, if possible.
  • Teach her to wash her hands often.

What's the most important thing to know about sore throat?

Strep throat should be treated with antibiotics, but antibiotics should not be used for the much more common kinds of sore throat caused by viruses.

References

Robert H. Pantell M.D., James F. Fries M.D., Donald M. Vickery M.D., Taking Care of Your Child: A Parent's Illustrated Guide to Complete Medical Care. Da Capo Press. 2005.

Brigham and Womens Hospital. Kids Too Often Prescribed Antibiotics for Sore Throat. February 2005. http://news.harvard.edu/gazette/story/2005/11/kids-too-often-prescribed-antibiotics-for-sore-throat/

American Academy of Pediatrics, HealthyChildren.org. When a Sore Throat Is a More Serious Infection. http://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/pages/When-a-Sore-Thoat-is-a-More-Serious-Infection.aspx

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