Sore Throat

Definition

  • Pain, discomfort or raw feeling of the throat
  • Made worse when swallows
  • Rare symptom before 2 years old
  • Not caused by an injury to the throat

Causes·    

  • 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. 
  • Viral pharyngitis. Some viruses cause a sore throat without nasal symptoms. 
  • Strep pharyngitis. Group A Strep is the most common bacterial cause. It accounts for 20% of persistent sore throats. Only these need an antibiotic.

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 your child to delay treatment until a Strep test can be done.
  • Standard treatment is with antibiotics by mouth.

Symptoms in Infants and Toddlers

  • Children less than 2 years of age usually don'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. Their symptoms are usually better covered using DRINKING FLUIDS -DECREASED guide.

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.

When to Call Us for Sore Throat

Call 911 Now (your child may need an ambulance) If

  • Severe trouble breathing (struggling for each breath, can barely speak or cry)
  • You think your child has a life-threatening emergency

Call Us Now (night or day) If

  • Your child looks or acts very sick
  • Trouble breathing, but not severe
  • Great trouble swallowing fluids or spit
  • New drooling
  • Stiff neck
  • Dehydration suspected. (No urine in over 8 hours, dark urine, very dry mouth and no tears)
  • Purple or blood-colored spots or dots on skin
  • Weak immune system. (Such as sickle cell disease, HIV, cancer, organ transplant, taking oral steroids)
  • Fever over 104° F (40° C)
  • You think your child needs to be seen urgently. (Note: A Strep test is not urgent)

Call Us During Weekday Office Hours If

  • Sore throat is the main symptom and lasts more than 48 hours
  • Sore throat with cold/cough symptoms lasts more than 5 days
  • You have other questions or concerns

Parent Care at Home If

  • Viral throat infection suspected

CARE ADVICE FOR SORE THROATS

What You Should Know:
  • 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.
  • Here is some care advice that should help.
Sore Throat Pain Relief:
  • Age over 1 year. Can sip warm fluids such as chicken broth or apple juice.
  • 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. See Dose Table.
Fever:
  • For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. See Dose Table. Note: Lower fevers are important for fighting infections.
  • For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.
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.
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.
What to Expect:
  • Most often, sore throats with a viral illness last 4 or 5 days.
Call Your Doctor If:
  • 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
  • Your child becomes worse
Scarlet Fever Rash


And remember, contact us if your child develops any of the "Call Us" symptoms.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Copyright 1994-2013 Barton D. Schmitt, M.D.