Sore Throat

DEFINITION

• Pain, discomfort or raw feeling of the throat, especially when swallowing.

• 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.

• Symptoms include sore throat, fever, headache, abdominal pain, nausea and vomiting
• Cough, hoarseness, red eyes, and runny nose are usually not seen with Strep throat and are more suggestive of a viral cause.
• Scarlet fever rash (fine, red, sandpaper-like rash) is highly suggestive of Strep throat
• Peak age: 5 to 15 years old.  Uncommon under 2 years old unless sibling has strep.
• Diagnosis should be confirmed by throat culture prior to starting treatment (there is no risk to your child to delaying treatment until a throat culture can be performed).
• Acute Rheumatic Fever may occur in children not treated within ten days of symptom onset.
• Standard treatment is with penicillin or amoxicillin, other antibiotics may sometimes be used.

• Children less than 2 years of age usually don't know how to complain about a sore throat. A young child who refuses previously enjoyed foods or begins to cry during feedings may have a sore throat. Their symptoms are usually better covered using the DRINKING FLUIDS -DECREASED guideline.

• Your child can return to child care or school after the fever is gone and your child feels well enough to participate in normal activities. Children with Strep throat also need to be taking an oral antibiotic for 24 hours before they can return.

See More Appropriate Topic (instead of this one) If

• The main symptom is croup, hoarseness or a cough, see CROUP or COUGH (Note: these symptoms are rarely seen with Strep.)
  
  

WHEN TO CALL YOUR DOCTOR

HOME CARE ADVICE FOR SORE THROATS

1. Reassurance: Most sore throats are just part of a cold. The presence of a cough, hoarseness or nasal discharge points to a cold as the cause of your child's sore throat.
2. Local Pain Relief:
   • Children over age 1 can sip warm chicken broth, apple juice or other warm fluid.
   • Children over age 6 can suck on hard candy (e.g., butterscotch) or lollipops.
   • Children over age 8 can also gargle warm water with a little table salt or liquid antacid added.
   • Medicated throat sprays or lozenges are generally not helpful.
3. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for severe throat discomfort or fever greater than 102° F (39° C).
4. Soft Diet: Cold drinks and milk shakes are especially helpful. (Reason: Swollen tonsils can make some solid foods hard to swallow.)
5. Contagiousness:
   • Your child can return to child care or school after the fever is gone and your child feels well enough to participate in normal activities.
   • Children with Strep throat also need to be taking an oral antibiotic for 24 hours before they can return.
6. Expected Course: Sore throats with viral illnesses usually last 4 or 5 days.
7. Call Your Doctor If:
   • Sore throat is the main symptom and lasts over 48 hours
   • Sore throat with a cold lasts over 5 days
   • Fever lasts over 3 days
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.