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.
Sudden health concerns rarely seem to happen between nine and five. That's why we always have staff on duty 24/7, including holidays and weekends. The call is free, so why wait and worry?
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