Sore Throat in Children

Sore throat is a common problem during childhood, and is usually the result of a bacterial or viral infection. Although sore throat usually resolves without complications, it sometimes requires treatment with an antibiotic. There are some less common causes of sore throat that are serious or even life-threatening.

Causes of Sore Throat

Viruses – There are many viruses that can cause pain and swelling of the throat. The most common include common cold viruses, influenza, adenovirus, and Epstein-Barr virus (Infectious mononucleosis-Glandular Fever).

Symptoms that may occur with a viral infection can include a runny nose and congestion, irritation or redness of the eyes, cough, hoarseness, soreness in the roof of the mouth, a skin rash, or painful to swallow. In addition, children with viral infections may have high fever.

Beta hemolytic streptococcus — Group A streptococcus is the name of the bacterium that causes strep throat. Although other bacteria can cause a sore throat, this is the most common bacterial cause; up to 30 percent of children with a sore throat will have this.

Symptoms of strep throat in children older than 3 years often develop suddenly and include fever (temperature ≥100.4ºF or 38ºC), headache, abdominal pain, nausea, and vomiting. Other symptoms can include swollen glands in the neck, white patches of pus in the back or sides of the throat, small red spots on the roof of the mouth, and swelling of the uvula

A small percentage of young children with a sore throat may have a foreign body (e.g., toy, coin, food) stuck in the throat, esophagus, or respiratory tract.

Laboratory testing -Throat swab for microscopy and culture, blood tests have to be done.

Treatment

The treatment of sore throat depends upon the cause; strep throat is treated with an antibiotic while viral Pharyngitis is treated with rest, pain relievers, and other measures to reduce symptoms.

Strep throat is usually treated with an antibiotic, such as penicillin, or an antibiotic similar to penicillin (e.g., amoxicillin). Children who are allergic to penicillin will be given an alternate antibiotic. IV antibiotics are given if no improvement after oral medication.

After completing 24 hours of antibiotics, the child is no longer contagious and may return to school. Symptoms usually improve within 1 to 2 days. However, it is important for the child to finish the entire course of treatment (usually 5-7days).

Sore throat caused by viral infections usually last 4 to 5 days. During this time, treatments to reduce pain may be helpful but will not help to eliminate the virus. Antibiotics do not improve throat pain caused by a virus and are not recommended.

Steroid-A short course of steroid do wonders in case of severe viral sore throat, not responding to other symptomatic treatment.

Pain killers– Throat pain can be treated with a mild pain reliever such as acetaminophen or a non-steroidal anti-inflammatory agent such as ibuprofen these medications should be dosed according to weight, not age.

Aspirin is not recommended for children <16 years due to the risk of a potentially serious condition known as Reye syndrome.

Monitor for dehydration -Some children with a sore throat are reluctant to drink or eat due to pain. Drinking less fluid can lead to dehydration. To reduce the risk of dehydration, parents can offer warm or cold liquids.

Oral rinses

Salt-water (warm) gargles are an old stand-by for relief of throat pain. Most recipes suggest 1/4 to 1/2 teaspoon of salt per cup of warm water. The water should be gargled and then spit out, not swallowed. Children younger than six to eight years are not able to gargle properly.

See your ENT surgeon

If your child with throat pain and one or more of the following –

and Difficulty swallowing or breathing

and Excessive drooling in an infant or young child

and Temperature ≥101ºF or 38.3ºC

and Swelling of the neck

and Child is unable or unwilling to drink or eat

and Voice sounds muffled

and Child has a stiff neck or difficulty opening the mouth