Clinical Reference Systems: Pediatric Advisor 10.0

DESCRIPTION

• Your throat is sore.
• When examined with a light, the throat is bright red.

CAUSE

Most sore throats are caused by viruses and are part of a cold. About 10% of sore throats are caused by strep bacteria. A throat culture or rapid strep test is the only way to know whether a sore throat is caused by strep bacteria or a virus. Without treatment, a strep throat can have some rare but serious complications.

For further information on strep infections, see topic:

Strep Throat Infection.

Tonsillitis (temporary swelling and redness of the tonsils) is usually present with any throat infection, viral or bacterial. The presence of tonsillitis does not have any special meaning.

Teens who sleep with their mouths open often wake in the morning with a dry mouth and sore throat. It feels better within an hour of having something to drink. Use a humidifier to help prevent this problem.

Teens with a postnasal drip from draining sinuses often have a sore throat from frequent throat clearing. Talk to your physician about treatment for sinus infections.

EXPECTED COURSE

Sore throats caused by viral illnesses usually last 3 or 4 days.

Strep throat responds well to penicillin or other antibiotics. After you have been taking medication for strep for 24 hours, strep is no longer contagious. You can then return to school if your fever is gone and you are feeling better.

HOME CARE

1. Local pain relief

   Gargle with warm saltwater (1/4 teaspoon of salt per glass) or an antacid solution. Suck on hard candy (butterscotch seems to be a soothing flavor).

2. Diet

   Swollen tonsils can make some foods hard to swallow. Eat a diet of soft foods for a few days.

3. Fever and pain relief

   Take acetaminophen or ibuprofen for the sore throat or for fever over 102 degrees F (39 degrees C).

4. Common mistakes in treating sore throat
   • Avoid expensive throat sprays or throat lozenges. Not only are they no more effective than hard candy, but many also contain an ingredient (benzocaine) that may cause an allergic reaction.
   • Do not use leftover antibiotics from siblings or friends. Antibiotics help only strep throats. They have no effect on viruses, and they can cause harm. They also make it difficult to find out what is wrong if you become sicker.

5. Rapid strep tests

   Rapid strep tests are helpful only when their results are positive. If they are negative, a routine throat culture should be performed to pick up the 20% of strep infections that the rapid tests miss. Avoid rapid strep tests performed in shopping malls or at home because they tend to be inaccurate.

CALL YOUR PHYSICIAN IMMEDIATELY IF:

• You are having great difficulty swallowing (for example, you can't swallow your saliva).
• You are having difficulty breathing.
• You are feeling very sick.

CALL YOUR PHYSICIAN DURING OFFICE HOURS:

• To make an appointment for a throat culture.

  Exception: A throat culture is probably not necessary if your throat is just mildly sore AND the main symptom is croup, hoarseness, or a cough. Throat cultures are recommended for all other cases of sore throats because of an increased rate of acute rheumatic fever since 1987. Rheumatic fever is a complication of strep infections that can lead to permanent damage to the valves of the heart. The throat culture is not urgent, however, since treating a strep infection within 7 days of when it begins can prevent rheumatic fever.