Sore Throat

Pharyngitis, the medical term for a sore throat, is a very common problem for children. The diagnosis of pharyngitis can be a challenge.

A sore throat can be part of the common cold or it may be associated with a more serious illness like mononucleosis. Sore throats can develop life threatening complications, such as rheumatic fever or abscesses that can compromise breathing.


Many sore throats are caused by viruses, in which case antibiotics aren’t required because they don’t work against viruses. Other sore throats are caused by bacteria.

Some throat infections may not cause soreness, even when the tissues are bright red. A sore throat often comes with a white coating on the throat and tongue, or a rash on the neck, chest and back.

Sometimes, the first noticeable symptom of a throat problem in an infant is hoarseness. As long as no other symptoms appear, you can treat hoarseness with a cool mist vaporizer.

Your baby also may refuse food. If this is the case, give fluids instead.

If your baby begins to ­experience raspy breathing, difficulty breathing or blueness around the mouth, contact your child’s doctor immediately or go to the emergency ­department of a hospital skilled in caring for children.

If an older child complains of a sore throat — particularly one associated with coughing during a cold — soothe the tissues with a mixture of warm water or tea with honey and lemon juice.

Honey should not be given to a child under the age of 1 because of the risk of infant botulism.

Your doctor will consider whether a throat culture is needed to test for streptococcal sore throat. A swab is used to collect cells and material from the tonsils and throat. The swabs can be used for a rapid strep test and culture if needed. The rapid test results are available within minutes, and cultures generally take up to 48 hours.

Make sure your child rests, especially if he has a fever. Give lots of fluids, which are easy to swallow and will prevent dehydration.

Acetaminophen or ibuprofen may ease the discomfort and make it less painful for your child to take fluids. Use a cool mist humidifier to keep air moist, or set up an impromptu cool sauna in your shower.

Prevent the spread of possible disease by keeping your child isolated from other family members and friends. Wash hands often.


The tonsils, which are at the top of the throat on either side of the back of the tongue, function as part of the immune system. While they may help fight infections, they can sometimes become infected and inflamed themselves.

Your doctor can tell from the appearance of the tonsils if they are inflamed, but a throat swab will help determine if the cause is bacterial and if antibiotics are needed. Surgery to remove the tonsils is sometimes necessary for children with recurrent sore throats.


A sudden sore throat is more likely to be caused by a bacteria called streptococcus, rather than a virus, which tends to attack more gradually. If your child wakes up dramatically sicker than the night before with a sore throat, suspect strep.

Other symptoms of strep include fever, chills, headache, stomachache and a red, severely sore throat.

Children between the ages of 2 and 3 may have different symptoms, including moderate fever, cough, a head cold, vomiting and loss of appetite. Look for a red throat. (Children under age 2 rarely get strep throat.)

Your child’s doctor can perform a rapid strep test that will provide results in as little as 10 to 15 minutes. If it is strep, antibiotics will be prescribed. Remember to keep giving the medication until it’s all gone, even if your child seems to be feeling better.

Because strep easily spreads to others, keep your child home from school and day care. He can usually return after 24 hours of antibiotic treatment. The incubation period is three to five days, but if left untreated, strep can remain contagious for weeks.


Scarlet fever also is caused by streptococcus. It is characterized by a fine, raised rash that is rough to the touch. The rash can appear on any area of the body. In some patients, peeling of the skin on the hands, feet and sometimes the groin can occur in about a week after the onset of the infection.

Scarlet fever is no more harmful than strep throat, but it also must be treated with antibiotics. Again, give the medication until it’s all gone.

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