Download Sore Throat - Through the Years Pediatrics

Infections
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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
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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