How to treat sore throat for child

Sore throat - Diagnosis and treatment

Diagnosis

Your or your child's doctor may review the symptoms and medical history. He or she may conduct a physical exam that includes:

Using a lighted instrument to look at the throat, and likely the ears and nasal passages
Gently feeling the neck to check for swollen glands (lymph nodes)
Listening to your or your child's breathing with a stethoscope

Throat swab

In many cases, doctors use a simple test to detect streptococcal bacteria, the cause of strep throat. The doctor rubs a sterile swab over the back of the throat to get a sample of secretions and sends the sample to a lab for testing. Many clinics are equipped with a lab that can get a test result for a rapid antigen test within a few minutes. However, a second, often more reliable test, called a throat culture, is sometimes sent to a lab that returns results within 24 to 48 hours.

Rapid antigen tests aren't as sensitive, although they can detect strep bacteria quickly. Because of this, the doctor may send a throat culture to a lab to test for strep throat if the antigen test comes back negative.

In some cases, doctors may use a molecular test to detect streptococcal bacteria. In this test, a doctor swipes a sterile swab over the back of the throat to get a sample of secretions. The sample is tested in a lab. Your or your child's doctor may have accurate results within a few minutes.

Treatment

A sore throat caused by a viral infection usually lasts five to seven days and doesn't usually require medical treatment. Antibiotics don't help treat a viral infection.

To ease pain and fever, many people turn to acetaminophen (Tylenol, others) or other mild pain relievers.

Consider giving your child over-the-counter pain medications designed for infants or children, such as acetaminophen (Children's Tylenol, FeverAll, others) or ibuprofen (Children's Advil, Children's Motrin, others), to ease symptoms.

Never give aspirin to children or teenagers because it has been linked to Reye's syndrome, a rare but potentially life-threatening condition that causes swelling in the liver and brain.

Treating bacterial infections

If your or your child's sore throat is caused by a bacterial infection, your doctor or pediatrician will prescribe antibiotics.

You or your child must take the full course of antibiotics as prescribed even if the symptoms are gone. Failure to take all of the medication as directed can result in the infection worsening or spreading to other parts of the body.

Not completing the full course of antibiotics to treat strep throat can increase a child's risk of rheumatic fever or serious kidney inflammation.

Talk to your doctor or pharmacist about what to do if you forget a dose.

Other treatments

If a sore throat is a symptom of a condition other than a viral or bacterial infection, other treatments will likely be considered depending on the diagnosis.

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Lifestyle and home remedies

Regardless of the cause of your sore throat, these at-home care strategies can help you ease your or your child's symptoms:

Rest. Get plenty of sleep. Rest your voice, too.
Drink fluids. Fluids keep the throat moist and prevent dehydration. Avoid caffeine and alcohol, which can dehydrate you.
Try comforting foods and beverage. Warm liquids — broth, caffeine-free tea or warm water with honey — and cold treats such as ice pops can soothe a sore throat. Don't give honey to children younger than age 1.
Gargle with saltwater. A saltwater gargle of 1/4 to 1/2 teaspoon (1250 to 2500 milligrams) of table salt to 4 to 8 ounces (120 to 240 milliliters) of warm water can help soothe a sore throat. Children older than 6 and adults can gargle the solution and then spit it out.
Humidify the air. Use a cool-air humidifier to eliminate dry air that may further irritate a sore throat, being sure to clean the humidifier regularly so it doesn't grow mold or bacteria. Or sit for several minutes in a steamy bathroom.
Consider lozenges or hard candy. Either can soothe a sore throat, but don't give them to children age 4 and younger because of choking risk.
Avoid irritants. Keep your home free from cigarette smoke and cleaning products that can irritate the throat.
Stay at home until you're no longer sick. This can help protect others from catching a cold or other virus.

Alternative medicine

Although several alternative treatments are commonly used to soothe a sore throat, evidence is limited about what works. If you or your child needs an antibiotic for a bacterial infection, don't rely on alternative treatments alone.

Check with your doctor before using any herbal remedies, as they can interact with prescription medications and may not be safe for children, pregnant and breastfeeding women, and people with certain health conditions.

Herbal or alternative products for a sore throat are often packaged as teas, sprays or lozenges. Common alternative remedies include:

Slippery elm
Licorice root
Marshmallow root

Preparing for your appointment

If you or your child has a sore throat, make an appointment with your family doctor or your child's pediatrician. In some cases, you may be referred to a specialist in ear, nose and throat (ENT) disorders or an allergy specialist (allergist).

Here's some information to help you get ready for your appointment.

What you can do

Make a list of:

Symptoms you or your child has, and for how long
Key personal information, such as recent contact with someone who was ill
All medications, vitamins or other supplements you or your child takes, including doses
Questions to ask the doctor

For a sore throat, some basic questions to ask your doctor include:

What's likely causing these symptoms?
Are there other possible causes?
What tests are needed?
What treatment do you recommend?
How soon do you expect symptoms to improve with treatment?
How long will this be contagious? When is it safe to return to school or work?
What self-care steps might help?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask questions about you or your child. Your doctor might ask:

Are there symptoms other than a sore throat?
Have these symptoms included a fever? How high?
Has there been difficulty breathing?
Does anything worsen the sore throat, such as swallowing?
Does anything seem to make the symptoms better?
Has anyone else at home been ill?
Is a sore throat a recurring problem?
Do you smoke? Are you or your child regularly exposed to secondhand smoke?

By Mayo Clinic Staff

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Sore Throat (Viral)

Nationwide Children’s Hospital

Two different germs cause sore throats – viruses and bacteria. They are both contagious and easily spread to others.

The germs hang out in the nose and throat. When the infected person coughs, sneezes, or talks, the germs go into the air. They are then breathed in by others.
The germs can also land on things and be picked up by touching them.

Most often, a sore throat is caused by a virus like the flu or common cold. The sore throat will go away on its own in a few days without any treatment.

When a sore throat comes on fast, it may be caused by the bacteria streptococci (strep-tuh-kaak-sai), or strep. Antibiotics will not help treat viruses.

Symptoms of a Virus

If your child has a sore throat with any of these symptoms, it is likely due to a virus.

Sore throat, maybe red with yellow patches
Decreased appetite
Red, itchy, or watery eyes
Sleeping more than normal
Runny nose, stuffed nose, or sneezing
Fussiness
Cough
Hoarseness

Diagnosis

It is important to know if your child’s sore throat is due to a virus or to strep bacteria.

The doctor or health care provider will examine your child and ask about their symptoms.
If they suspect strep, 1 or 2 soft swabs will be brushed over the back of your child’s throat to do 1, or both, of the tests on the next page. Your child may gag a little.
- A rapid strep test (rapid antigen test) – It takes up to 30 minutes to get the results of a rapid strep test. You will stay until you get the results.
- A throat culture – Sometimes only this test is done. If your child had a rapid strep test first, the same swab can be sent to the lab for testing. It takes 1 to 2 days to get the results. The lab will notify your child’s doctor or health care provider, who will then let you know the results.
A positive rapid strep test or positive throat culture means that your child has strep throat. They must start to take antibiotic medicine right away. Early treatment can prevent harm to the body.
Let your child’s doctor know if they are a strep carrier. Strep carriers always test positive for strep even after taking antibiotics. Their sore throat will be treated like a virus.

How to Care For Your Child

There are things you can do to help your child feel better.

Give them soft, easy-to-swallow foods, like applesauce, mashed potatoes, hot cereal, or eggs. Do not force them to eat. Your child may not want to eat much if it hurts to swallow.
Give them lots of liquids, like water, Pedialyte^®, diluted apple juice, or popsicles. Give small amounts of liquid often (Picture 1).
To soothe a sore throat, for children:
- For children over age 1, give warm fluids like water, herbal tea with honey, or diluted apple juice. Do not give honey to children under age 1. For some children, cold fluids or popsicles can be soothing.
- For children over age 4, give throat or cough lozenges or use throat sprays. Read the label to know the right dose for your child. Do not use throat sprays that contain benzocaine, as this could cause a drug reaction.
- For children over age 6 who are able to gargle without swallowing, mix ½ teaspoon of table salt in 8 ounces of warm water. Have them swish and gargle the mixture 2 to 3 times a day for the next few days. Do not let your child swallow the salt water; have them spit it out.
For a fever or throat pain, give acetaminophen (such as Tylenol^®) or ibuprofen (Advil^®, Motrin^®) as directed. Read the label to know the right dose for your child. Do not give aspirin or products that contain aspirin.

How to Protect Others

Good hand washing is VERY important! Clean your hands and your child’s hands often with soap and water. Wash for 15 to 20 seconds, or the time it takes to sing the Happy Birthday song (Picture 2). If soap and water are not available, an alcohol-based hand sanitizer that contains at least 60% alcohol may be used. Rub hands until dry.
Make sure to wash your child’s drinking glass and eating utensils in hot soapy water before others use them.
Give your child a paper bag and have them put their used tissues in this bag. Moisture from the child’s nose and mouth is contagious.

When to Call the Doctor

Call your child's doctor of health care provider if they:

Start pulling at their ears.
Have a sore throat that lasts more than 3 days.
Have trouble breathing.
Start drooling, can't talk, or voice gets muffled.
Can't eat or drink.
Have a fever:
- Younger than 3 months of age - 100.4° Fahrenheit (F) or 38° Celsius (C) or above.
- Older than 3 months of age
  - 104° F (40° C) or above.
  - Above 102° F (38.9° C) for more than 2 days or it keeps coming back.
  - Treated to bring their fever down, but it hasn’t worked.
- Any age - call with a fever and:
  - Has an unusual rash.
  - Looks ill, is fussy, or is drowsy.
  - Has been in a very hot place, such as an overheated car.
  - Is not eating or drinking and shows signs of dehydration - dry or sticky mouth, sunken eyes, dark urine, dry diapers, or not urinating.
  - Has a stiff neck, a bad headache, a very sore throat, a painful stomach ache, vomiting, or diarrhea.
  - Has immune system problems that make them more likely to get sick, such as sickle cell disease or cancer, or takes medicine that weakens the immune system.

Sore Throat (Viral) (PDF), Somali (PDF), Spanish (PDF)

If a child has a sore throat

A child has a sore throat: what and how should parents do in this case?

consultation of a pediatrician at the medical center "Onni"

Sore throat is one of the common causes of outpatient and emergency visits by parents of children to doctors for help. Upper respiratory tract infections are very common in both children and adults and have significant economic consequences due to the frequent prescription of antibiotics by physicians, even when the infection is not caused by bacteria. About a quarter of children suffering from tonsillitis also suffer from bacterial pharyngitis. Identification and adequate antibiotic treatment of group A streptococcal angina is important for the primary prevention of acute rheumatic fever, which occurs in 3% of cases. Therefore, in any case, with a sore throat, it is necessary to show the child to the doctor in order to exclude diseases that are dangerous to health and life. nine0005

How does a sore throat manifest itself?

The main symptom of a sore throat is pain, both at rest and when swallowing or talking. Sore throat is the primary symptom of pharyngitis. The terms "tonsillitis" and "pharyngitis or pharyngotonsillitis" are often used interchangeably. Pharyngitis refers to the objective signs of inflammation of the pharynx: edema, exudate, ulceration, or overt erythema. Redness of the throat may occur as part of a general redness of all the mucous membranes of the upper respiratory tract in small patients with fever. The diagnosis of pharyngitis is justified only when the pharynx is objectively redder than the rest of the mucous membranes. nine0005

What could be the causes of a sore throat?

Most often, sore throats are caused by viruses. Less commonly, sore throats occur due to bacterial infections. Viral pathogens such as coronovirus, rhinovirus, adenovirus, influenza and parainfluenza are the most common and usually present as the common cold. Other viral infections that can present with sore throats are the Epstein-Barr virus and HIV, which cause sore throats early in the course of the disease.

Recurrent angina may be due to cytomegalovirus or fungal infections in immunocompromised young patients.

Group A beta-hemolytic streptococcus (GABHS) is the most common cause of bacterial angina among bacterial infections. It accounts for 15–36% of cases of acute pharyngitis in children in developed industrial countries. Streptococcus types C and G may be other pathogens.

More rare causes of sore throat include infection with Staphylococcus aureus, Mycoplasma, Chlamydia pneumoniae, Moraxella catarrhalis, and Yersinia. nine0005

Fusobacterium necrophorum infection is an uncommon infection that begins with fever and sore throat and can subsequently develop into Lemierre's syndrome, which is characterized by blood poisoning, internal jugular vein thrombosis, and at least one metastatic infection.

Another group of causes of sore throat in children are peritonsillar, pharyngeal and lateral pharyngeal abscesses, which occur due to the spread of infection from local sources, such as bacterial tonsillitis. Along with fever and sore throat, other symptoms may be present in these cases, such as painful swallowing, drooling, trismus, visible swelling under the lower jaw, and deviation of the uvula away from the inflammation. nine0005

Sore throats can also be caused by allergies, especially when complicated by nasal bleeding. Irritants such as dust, tobacco and stove smoke, and chemical air pollutants can lead to chronic sore throats.

Prolonged conversation in raised tones, shouting for a long time also lead to sore throat.

Sore throat can also occur due to damage to the larynx by gastric juice in gastroesophageal reflux disease (GERD). nine0005

What signs of the disease are assessed by the doctor?

When taking a history of examining a child, the doctor will pay attention to the following symptoms:

Onset and duration of sore throat
Severity of fever
Associated cough, runny nose, conjunctivitis, headache, myalgia (muscle pain)
Any difficulty in breathing, especially nighttime snoring or stridor
History of rash, diarrhea or allergy

Family history of sore throat in the last 2 weeks.
Similar complaints in the past,
Vaccination history

When examining the throat, a doctor may notice:

White or gray deposits on the surface of the tonsils or pharynx that are easily rubbed off without bleeding.
Ulcerations
Film-like plaques characteristic of infectious mononucleosis, diphtheria, and sometimes streptococcal infections. Tularemia can also be a rare cause of such raids. nine0041
Films of gray or black color, extending beyond the tonsils, with swallowing disorders and the absence of severe fever, are characteristic of diphtheria.
Oral thrush, which is common in newborns and infants, may have a pseudomembrane (cheesy plaques), removal of which can cause mild pinpoint bleeding.
Oropharyngeal bulge or uvula lateral displacement indicates a parapharyngeal or peritonsillar abscess. nine0041
Herpetic sore throat is characterized by painful vesicular (bubbly) formations on the pharynx and tonsils. Herpes simplex develops painful blisters limited to the front of the mouth, which can sometimes spread to the front of the tonsils.
Lymphadenopathy (enlarged and painful anterior and posterior cervical lymph nodes are characteristic of bacterial tonsillitis or Epstein-Barr virus infection.
Streptococcal pharyngitis is characterized by sore throat, fever ≥38.3°C, plaque on the tonsils and pharynx, and cervical lymphadenopathy. nine0041
Cough, runny nose and diarrhea are more common in viral pharyngitis.

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Additional tests for sore throat

The main problem in diagnosing sore throat is not to miss the dangerous diagnoses of diphtheria and GABHS angina. For this, a throat swab is taken from the child for bacterial and culture, including Albert stain for diphtheria. A provisional diagnosis of diphtheria is suggested if typical tympanic bacillus organisms are found in the smear. However, definitive diagnosis requires confirmation of growth of C. diphtherium in culture.

For the diagnosis of GABHS angina, there are antigen rapid tests. Their action is based on the extraction of group A carbohydrate antigen from throat swab materials with nitrous acid. These rapid tests are very specific (> 95%) and give immediate results but have variable sensitivity. Confirmation of a positive result is not required, and if negative, culture is recommended to exclude an infection dangerous for the child. A streptococcal antibody titer is not useful in diagnosing strep pharyngitis and is not usually recommended.

Other tests:

Complete blood count
Peripheral blood smears - for the presence of atypical lymphocytes.
Epstein-Barr virus serology (IgM antibodies)
X-ray of the soft tissues of the neck (lateral view) in case of suspected retropharyngeal abscess.
CT scan of the neck, including the base of the skull, for an abscess.

Treating a child with sore throat

Prescriptions must be made by a doctor based on the established diagnosis and identified or suspected pathogen. Self-administration of drugs by parents is unacceptable. This can lead to serious consequences for the health of the child.

GABHS farnigitis is a disease that resolves on its own. However, antibiotic treatment in this case provides rapid relief of symptoms, prevents purulent (otitis media, sinusitis, tonsillitis) and non-suppurative complications, and also reduces the possibility of infection transmission. Antibiotics reduce the incidence of rheumatic fever by more than two-thirds.

Clinical features, epidemiological criteria, and judgment by an experienced clinician, with or without additional evaluation, usually indicate the need for antibiotics. The currently used score for decision making in pharyngitis has been adapted by adding age to the four components of the original Centor score (no cough, swollen and painful anterior cervical nodes, temperature >38°C, tonsil plaque or swelling. Each component is given 1 point. For age 3 to 14 years is also given a score of 1. Children or adolescents with a score of 0 or 1 do not require antibiotic therapy. scores of 4 or higher are at high risk for streptococcal GABHS pharyngitis and should receive antibiotic therapy.

Due to cost, narrow spectrum, safety and efficacy, penicillin is the drug of choice. A shorter duration of treatment increases the risk of bacteriological recurrence of the disease. The unreasonable use of macrolides for the treatment of GABHS pharyngitis has become the main reason for the formation of resistant strains of pathogens.

What can parents do to relieve their child's sore throat?

Here are some simple ways children can help relieve sore throats:

Drink warm liquids
Have cold or frozen liquids (eg sorbet or ice cream)
Gargle with salt water
Suck throat lozenges (for children aged 4 and over)
Give the child ibuprofen or acetaminophen as needed

When should I see a doctor urgently?

Seek immediate medical attention if the child:

has trouble swallowing
does not drink liquids
drooling
extremely lethargic
Pus is visible in the back of the throat
severe sore throat lasting longer than a few days

Do not self-medicate. Beautiful and saving from “everything in the world” medicines from advertisements in cute jars (with “bears and bunnies”) are not the best solution if the diagnosis is not clear. Medicines for the child should be prescribed by a doctor. Especially antibiotics.

Seeing a doctor about a sore throat in a child is not a whim, but a necessity. We are always happy to help. The sooner your child gets the right treatment, the less chance of complications.

Call a doctor at home To make an appointment with a doctor or call +7 (812) 331-17-74

Treatment of sore throat in children

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