Sore Throat Pharyngitis

Category

ENT

Sore Throat (Pharyngitis)

What is a sore throat?

When your child complains that his throat is sore, it is usually a symptom of an illness, such as a cold. When you look at the throat with a light, it will be bright red. Children too young to talk may have a sore throat if they refuse to eat or begin to cry during feedings.

What is the cause?

Most sore throats are caused by viruses and are part of a cold. About 10% of sore throats are caused by strep bacteria. A throat culture or rapid strep test is the only way to know whether a sore throat is caused by strep bacteria or a virus. Without treatment, a strep throat can have some rare but serious complications.

Tonsillitis (temporary swelling and redness of the tonsils) usually occurs with any throat infection, viral or bacterial. Swollen tonsils do not have any special meaning.

Children who sleep with their mouths open often wake up in the morning with a dry mouth and sore throat. It feels better within an hour of having something to drink. Use a humidifier to help prevent this problem.

Children with a postnasal drip from draining sinuses often have a sore throat from clearing their throat often.

How long does it last?

Sore throats caused by viral illnesses usually last 4 or 5 days.

A sore throat caused by Strep will start feeling better soon after being treated with penicillin or other antibiotics. After a child has been taking medication for strep for 24 hours, strep is no longer contagious. Your child can then return to day care or school if his fever is gone and he's feeling better.

How can I take care of my child?

• Throat pain relief Children over age 1 can sip warm chicken broth or apple juice. Children over age 4 can suck on hard candy (butterscotch seems to be a soothing flavor) or lollipops. Children over 8 years old can also gargle with warm salt water (1/4 teaspoon of salt per glass).
• Diet Swollen tonsils can make some foods hard to swallow. Provide your child with a diet of soft foods for a few days if he prefers it.
• Fever and pain relief Give your child acetaminophen (Tylenol) or ibuprofen (Advil) for the sore throat or for a fever over 102°F (39°C).
• Common mistakes in treating sore throat
  • Avoid expensive throat sprays or throat lozenges. Not only are they no more effective than hard candy, but many also contain an ingredient (benzocaine) that may cause an allergic reaction.
  • Do not use leftover antibiotics from siblings or friends. Leftover antibiotics should be thrown out because they deteriorate faster than other drugs. Also, antibiotics help only strep throats. They have no effect on viruses, and they can cause harm. They also make it difficult to find out what is wrong if your child becomes sicker.
• Rapid strep tests Rapid strep tests are helpful only when their results are positive. If they are negative, a throat culture should be performed to pick up the 20% of strep infections that the rapid tests miss. Avoid rapid strep tests performed in shopping malls or at home because they tend to be inaccurate.

When should I call my child's health care provider?

Call IMMEDIATELY if:

• Your child is drooling or having great difficulty swallowing.
• Your child is having difficulty breathing.
• Your child is acting very sick.

Call during office hours if:

• To make an appointment for a throat culture for any other child who has had a sore throat for more than 24 hours (especially if the child also has a fever).

Exception: A throat culture is probably not necessary if your child's sore throat is part of a cold AND the main symptom is croup, hoarseness, or a cough. Throat cultures are recommended for all other cases of sore throats because of a small risk for acute rheumatic fever. Rheumatic fever is a complication of strep infections that can lead to permanent damage to the valves of the heart. The throat culture is not urgent, however, since treating a strep infection within 7 days of when it begins can prevent rheumatic fever.