Sore Throat

Is this your child's symptom?

Pain or discomfort of the throat
Made worse when swallows
Rare symptom before 2 years old
Not caused by an injury to the throat

Causes of Sore Throat

Colds. Most sore throats are part of a cold. In fact, a sore throat may be the only symptom for the first 24 hours. Then a cough and runny nose occur.
Viral Pharyngitis. Some viruses cause a sore throat without other symptoms. A cough and runny nose don't become part of the illness. An antibiotic won't help.
Strep Pharyngitis. Group A Strep is the most common bacterial cause. It accounts for 20% of sore throats without any cold symptoms. Pus is seen on the tonsils. Peak age is 5 to 15 years. An antibiotic is helpful.
Mono. Infectious Mono mainly occurs in teens and young adults. The main symptoms are sore throat, fever and widespread swollen lymph nodes. Like Strep, Mono also has pus on the tonsils. Patients with Mono also may have a large spleen. It's located in the upper left side of the stomach. Mono is diagnosed with special blood tests.
Post-nasal Drip. Drainage from a sinus infection can cause a sore throat. The throat clearing that goes with the drainage may cause most of the irritation. The sinus infection is more likely to be viral than bacterial.
Mouth Breathing. Breathing with the mouth open during sleep can cause a sore throat. After eating breakfast, it often goes away.
Abscess of Tonsil (Serious). A bacterial infection of the tonsil can spread to the surrounding tissues. The main symptoms are severe trouble swallowing, fever and one-sided throat pain. It's also hard to fully open the mouth. The peak age is teens.
Epiglottitis (Very Serious). A bacterial infection of the flap of tissue above the vocal cords. It normally covers the windpipe during swallowing. The main symptoms are severe sore throat, drooling, spitting and fever. It can shut off the airway. Needs a 911 response.

Strep Throat: When to Suspect

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.
If you think your child has Strep, call your doctor.
Your doctor will do a Strep test. If the test is positive, they will start treatment. There is no risk from waiting 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 care guide.

When to Call for Sore Throat

When to Call for Sore Throat
Call 911 Now Severe trouble breathing (struggling for each breath, can barely speak or cry) Purple or blood-colored spots or dots on skin with fever You think your child has a life-threatening emergency Call Doctor or Seek Care Now Trouble breathing, but not severe Great trouble swallowing fluids or spit Can't open mouth all the way Stiff neck or can't move neck like normal Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears. Weak immune system. Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids. Fever higher than 104° F (40° C) Your child looks or acts very sick You think your child needs to be seen, and the problem is urgent. Note: a Strep test alone is not urgent.	Contact Doctor Within 24 Hours Sore throat pain is severe and not better 2 hours after taking ibuprofen Large lymph nodes in the neck Pink rash that's widespread Earache or ear drainage Sinus pain (not just congestion) around cheekbone or eyes Fever lasts more than 3 days Fever returns after being gone more than 24 hours Age less than 2 years old Close contact to a person with Strep within last 7 days Sores on the skin You think your child needs to be seen, but the problem is not urgent (or needs a Strep test) Contact Doctor During Office Hours 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	Self Care at Home Viral throat infection suspected

Call 911 Now

Severe trouble breathing (struggling for each breath, can barely speak or cry)
Purple or blood-colored spots or dots on skin with fever
You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

Trouble breathing, but not severe
Great trouble swallowing fluids or spit
Can't open mouth all the way
Stiff neck or can't move neck like normal
Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears.
Weak immune system. Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
Fever higher than 104° F (40° C)
Your child looks or acts very sick
You think your child needs to be seen, and the problem is urgent. Note: a Strep test alone is not urgent.

Contact Doctor Within 24 Hours

Sore throat pain is severe and not better 2 hours after taking ibuprofen
Large lymph nodes in the neck
Pink rash that's widespread
Earache or ear drainage
Sinus pain (not just congestion) around cheekbone or eyes
Fever lasts more than 3 days
Fever returns after being gone more than 24 hours
Age less than 2 years old
Close contact to a person with Strep within last 7 days
Sores on the skin
You think your child needs to be seen, but the problem is not urgent (or needs a Strep test)

Contact Doctor During Office Hours

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

Self Care at Home

Viral throat infection suspected

Care Advice for Sore Throats

What You Should Know About Sore Throats:

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.
Most children with a sore throat don't need to see their doctor.
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. Some children prefer cold foods such as popsicles or ice cream.
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.
Honey for age 1 year and older. Honey can be helpful for soothing a sore throat. Amount: offer 5 mL (1 teaspoon) as needed for pain.
Medicated throat sprays or lozenges are generally not helpful.

Pain Medicine:

To help with the pain, give an acetaminophen product (such as Tylenol).
Another choice is an ibuprofen product (such as Advil).
Use as needed.

Fever Medicine:

For fevers higher than 102° F (39° C), give an acetaminophen product (such as Tylenol).
Another choice is an ibuprofen product (such as Advil).
Note: fevers less than 102° F (39° C) 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.
Solid Foods: 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 solid foods.
Swollen tonsils can make some solid foods hard to swallow. Cut food into smaller pieces.

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.
Most often, having just a sore throat is not a reason to miss school.
Children with Strep throat need to be taking an antibiotic for at least 12 hours.