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Transcript
Infections www.throughtheyearspediatrics.com Sore Throat Sore throat is one of the most common complaints we see in our office. Sore throats are usually caused by infections, both viral and bacterial, but can occasionally be caused by other sources such as allergies. Distinguishing between viral and bacterial sore throats can be difficult based on examination alone. Bacterial infections of the throat usually cause fever, sore throat and swollen glands in the neck. Bacterial infections that cause sore throat do not usually cause runny nose, nasal congestion or cough. In order to distinguish between bacterial and viral infections that cause sore throat, we will most likely need to perform a rapid strep test in the office by swabbing your child's throat with a cotton swab. This rapid strep test is fairly accurate, but if the test is negative and we suspect strep throat we will send a second swab to the lab for a throat culture. Throat cultures take several days to return. In children, aged 5 to 15, up to 30% of sore throats are caused by the bacteria Group A Streptococcus, also known as strep throat. Children under age 3 generally should not be tested for strep throat as they rarely have strep throat; they do not develop rheumatic heart disease and usually will recover without antibiotic therapy. Sometimes we will test young children if they have had a significant exposure to strep throat or they have a physical examination consistent with strep throat. Children with strep throat generally have fever of 100.4 or more, sore throat, headache and/or abdominal pain. Sometimes your child will develop a rash as well. When this happens, strep infection is called scarlet fever. They do not usually have cough or runny nose. Strep throat requires treatment with antibiotics to prevent a condition called rheumatic heart disease that can result in damage to heart valves and to improve your child's symptoms quickly as well as decrease his contagiousness to others. As long as treatment is started within the first week of the infection, rheumatic heart disease is preventable. Strep throat is contagious and your child should not return to school until he has completed at least 24 hours of antibiotic therapy. For more information regarding testing and treatment of strep throat, you may review the Infectious Disease Society of America's guidelines here. The majority of sore throats in children are caused by viral infections, such as adenovirus, coxsackie virus, rhinovirus, and Epstein Barr virus. Children with these infections frequently have fever, cough, runny nose, nasal congestion, or sores in their mouth. Viral infections do not respond to antibiotics and treatment is directed at making your child more comfortable while his body fights the infection. Occasionally, sore throats are not caused by infections but other sources of postnasal drip, 15316 Huebner Rd, Ste 102; San Antonio, TX 78248 (210) 479-9292 www.throughtheyearspediatrics.com Infections such as nasal allergies. When sore throat is caused by postnasal drip, the sore throat is usually worse in the morning and improves throughout the day. These children generally act well and do not have fever. They will frequently have other allergy symptoms such as sneezing, itchy watery eyes, itchy nose or cough. Trying an over the counter antihistamine such as loratadine, cetirizine or fexofenadine may be helpful for these children along with other symptomatic care. You should seek immediate care for your child with a sore throat if your child is having difficulty breathing or swallowing, complaining of a stiff neck, having excessive drooling, refusing to drink anything, or having difficulty opening their mouth. Your child should see us in the office during regular business hours for sore throat to determine the need for antibiotic therapy if your child has fever over 101 with sore throat but no cough, congestion or runny nose; has a sore neck; has been exposed to anyone with strep throat; has a rash; is not drinking fluids well or other concern. If your child is diagnosed with strep throat, you should begin antibiotics as prescribed and complete the entire course of antibiotics. Your child should begin feeling better within 1 to 2 days and may return to school when he has been on antibiotics for at least 24 hours, is without fever, and is feeling well enough to participate in school activities. You should call our office if your child is not feeling in better in 1 to 2 days, continues with fever for more than 2 days, has trouble or refuses to drink fluids, has trouble opening his mouth, is vomiting and unable to take his antibiotic, has a stiff neck or swollen neck or any other concerns. For most viral infections, your child should be without fever in 3 to 4 days. You should offer your child symptomatic care with acetaminophen or ibuprofen, soothing liquids and soft foods. Children over 4 years of age may try sucking on hard candies or lollipops. Children with viral infections may return to school when they have been without fever for 24 hours and are well enough to participate in normal school activities. To help prevent infections that cause sore throat, remind your child to wash his hands frequently and to avoid putting his hands in his mouth or touching his nose or eyes. 15316 Huebner Rd, Ste 102; San Antonio, TX 78248 (210) 479-9292