Sore Throat Spectrum: Runny Nose to Strep and Everything in Between

Sore throat can occur on its own, for multiple reasons, or it can be the sign of another illness. So, how do you know if your child should see a doctor?

Cold and flu viruses are some of the most common causes for a sore throat and some bacterial infections, included streptococcus (strep throat) can also cause a sore throat, but symptoms can also occur without being related to an illness.  Post-nasal drainage from seasonal allergies or a cold or sleeping with an open mouth, which dries out the mouth and throat, can also be causes.

Symptoms of a sore throat include difficulty when swallowing or talking and a burning, itchy, or scratchy sensation. Very young children may eat or drink smaller amounts than they normally do or refuse to eat and drink altogether. Advanced symptoms can include fever, a hoarse or raspy voice, swollen glands, nausea, and the throat might be more red than normal, possibly with pus.

Caring for a child’s sore throat at home involves providing lots of liquids and soft foods and rest. Children over twelve months old can be given pasteurized honey (do not give honey to infants; it can cause botulism due to their still-immature digestive system), and older kids can gargle with warm salt water to get some relief as well as to drink lots of liquids to stay very hydrated.

After making an effort to treat sore throat at home with no marked improvement, it might be time for a consultation with a medical professional.

A child should be seen by their pediatrician if they develop the following symptoms:

  • Difficulty breathing
  • Lethargy
  • Pus in the throat
  • A sore throat that hangs on for more than seven days
  • Persistent fevers
  • Rash
  • Worsening ability to eat/drink

Strep throat symptoms can advance very quickly and may be severe. Two to five days post-exposure is when symptoms begin, and usually fever is the first indicator. Because of the long list of symptoms associated with this infection, it can be difficult to diagnose in children. A doctor should be seen immediately if the child has been in close contact with another person who has strep and, in the meantime, keep them away from other children as much as you can.

A rapid strep test from a throat swab can be done in the doctor’s office, and a negative result should be followed by a throat culture to be sure. Results from a throat culture can take forty-eight hours but are considered to be the most accurate.

Stubborn, severe or frequently re-occurring strep throat in a child might indicate the need for a tonsillectomy. Reasons to get your tonsils removed are more than three confirmed strep tonsil infections in six months, more than six to seven confirmed strep tonsil infections in 12 months, or more than three confirmed strep tonsil infections per year for two or more years). Additional reasons to get your tonsils removed are also from your child getting an abscess around the tonsils that often has to be drained surgically.

Note: Children can still get diagnosed with strep throat after tonsils are removed; though typically the frequency and severity are very reduced. In these cases, your child may have strep that often lives harmlessly in their throat and will be found every time your child gets their throat swabbed.

For more information on Nationwide Children’s Hospital’s ear, nose and throat services, click here.

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