Sore throats are a very common complaint in children during the late fall and winter months. They arise from inflammation of any throat structure (tonsils, pharynx etc…), and in most cases, are mild and require no special treatment.
While most sore throats are caused by viruses, it can often be difficult to tell the difference between a viral or bacterial infection. Both are associated with fever and redness of the throat and tonsils. However, a viral sore throat is usually associated with a runny nose and cough, while a bacterial sore throat is often associated with pus on the tonsils and tender swollen lymph nodes. Strep throat is unusual in children under 3 years of age. In addition, a rapid strep test or throat culture will be positive if the Strep bacteria (group A beta-hemolytic Streptococcus) is the source of the sore throat. In our office we will perform a rapid strep test and treat immediately if it’s positive. If the rapid strep test is negative in the office we then send off an actual culture (results take 24-48 hours). You will be called ONLY if your culture turns positive, and an antibiotic will then be prescribed. No antibiotic is necessary if both rapid test and culture are negative
Treatment for a sore throat is always supportive. Hydration is maintained by drinking a lot of fluid. In addition to acetaminophen or ibuprofen for fever and pain, children over one year of age may find some relief by drinking warm chicken broth, gargling with warm salt water (1/4 teaspoon salt per glass) or for children over four years of age, sucking on hard candy (specifically butterscotch). Antibiotics are used for proven bacterial infections only, because of the risk of developing Rheumatic Fever or kidney problems from an untreated Strep infection.
The usual duration of a viral sore throat is 3 to 4 days. Twenty-four hours after starting antibiotics for Strep throat, your child is no longer contagious and can return to day care or school if he or she is feeling better.
Call our office immediately if in addition to a sore throat, your child has excessive drooling or difficulty swallowing, difficulty breathing or is acting very sick.