Definition
- Pain, discomfort or raw feeling of the throat
- Made worse when swallows
- Rare symptom before 2 years old
- Not caused by an injury to the throat
Causes
- 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 If: Click to View
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
Call Us Within 24 Hours If: Click to View
Call Us Within 24 Hours (between 9 am and 4 pm) If:
- You think your child needs to be seen, but not urgently. (OR needs a Strep test)
- Sore throat pain is severe and not improved 2 hours after taking ibuprofen
- Large lymph nodes in the neck
- Pink rash that’s widespread
- Earache or sinus pain (not just congestion)
- Fever lasts more than 3 days
- Fever returns after gone for more than 24 hours
- Age under 2 years
- Close contact to a person with Strep within last 7 days
- Sores on the skin
Call Us During Weekday Office Hours If:
- You have other questions or concerns
- Sore throat is the main symptom and lasts more than 48 hours
- Sore throat with cold/cough symptoms lasts more than 5 days
Parent Care at Home If: Click to View
Parent Care at Home If:
- Viral throat infection suspected
Care Advice for Sore Throat
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