$Unique_ID{PAR00152}
$Pretitle{}
$Title{Medical Advice:  Sore Throat}
$Subtitle{}
$Author{
Editors of Consumer Guide
Chasnoff, Ira J}
$Subject{Sore Throat Pain Swollen lymph nodes neck swallowing Difficulty salt
water gargle acetaminophen pus-like discharge eyes nose earache sinus pain
breathing difficulties chest pain stiff neck weakness exhaustion confusion
vomiting virus viruses viral infections streptococcus bacteria bacterium
bacterial antibiotic antibiotics penicillin throat secretions throat culture
cultures culturing strep throat allergic erythromycin streptococcal infection
swollen glands reddish-purple rash scarlet fever}
$Log{}

Your Child:  A Medical Guide


Sore Throat


     Quick Reference

     SYMPTOMS
     - Pain
     - Swollen lymph nodes in the neck
     - Difficulty in swallowing

     HOME CARE
     - Have the child gargle with salt water and drink extra fluids.
     - Give acetaminophen to relieve pain.
     - Keep the child isolated until the cause of the sore throat has been
       diagnosed.

     PRECAUTIONS
     - A doctor should examine any child with a sore throat accompanied by any
       of the following symptoms:  swollen or tender lymph nodes in the neck,
       persistent difficulty in swallowing, pus-like discharge from the eyes
       or nose, earache, sinus pain, breathing difficulty, chest pain, rash,
       stiff neck, weakness or exhaustion, confusion, repeated vomiting.
     - Any child with a sore throat and fever that are still getting worse
       after 24 to 36 hours should be seen by a doctor.
     - A child with a sore throat should be kept away from other children,
       particularly infants, until a diagnosis has been made.


     In theory, a sore throat should be one of the simplest childhood medical
problems to diagnose and to treat.  Medical textbooks state that a sore throat
is usually caused by a virus and, therefore, does not require treatment with
antibiotics because viral infections do not respond to medication.  A sore
throat that is not caused by a virus is generally due to streptococcus
bacteria.  These organisms can be identified by culturing throat secretions,
and a strep throat can be treated with penicillin or, if the child is allergic
to penicillin, with erythromycin.
     In practice, however, the diagnosis and treatment of a sore throat are
not so straightforward.  Viral infections sometimes are complicated by
streptococcal infections.  A throat culture may isolate streptococcus
organisms, even though they are not the cause of the illness.  Furthermore,
about 5 percent of throat cultures will not show streptococcus organisms even
when they are present and are, in fact, the cause of the sore throat.  Some
bacterial illnesses that cause a sore throat will respond to antibiotics, but
the infecting bacteria cannot be identified with the use of an ordinary throat
culture.

SIGNS AND SYMPTOMS

     It is difficult to be certain that an infant or toddler has a sore throat
because the child cannot communicate, but swollen glands in the neck and
difficulty in swallowing are clues.  Determining the cause of a sore throat
depends on the results of blood tests and a throat or other type of culture,
as well as on the doctor's skill in performing the physical examination,
knowledge of the illnesses in the community, and professional judgment.

HOME CARE

     All children should drink extra fluids and eat their usual diet if they
can.  Older children may gargle with warm salt water to relieve a sore throat.
Give acetaminophen to reduce pain or fever, and isolate the child from other
children, particularly infants, until the cause of the problem has been found.

PRECAUTIONS

  -  Take the child to a doctor if a sore throat is accompanied by any of the
     following symptoms:  moderately or severely swollen and tender lymph
     nodes in the neck, difficulty in swallowing that cannot be relieved by
     acetaminophen, pus-like discharge from the eyes or nose, moderate or
     severe earache, tenderness over the sinuses, breathing difficulty,
     chest pain, reddish-purple rash or a rash resembling scarlet fever
     (fine, slightly raised red spots resembling coarse red sandpaper),
     stiff neck, weakness or exhaustion, confusion, or repeated vomiting.
  -  If a sore throat and a fever continue to worsen after 24 to 36 hours,
     consult a doctor.

MEDICAL TREATMENT

     Your doctor will conduct a complete physical examination and order a
throat culture and, perhaps, other laboratory tests.  Depending on the results
of these tests, your doctor may treat a sore throat with antibiotics.
Regardless of the treatment prescribed, you should report any new symptoms to
your doctor.  Also consult the doctor if there is no improvement in the
child's condition after 48 hours.

RELATED TOPICS:  Chest pain; Common cold; Coughs; Croup; Diphtheria; Earaches;
Fever; Glands, swollen; Gonorrhea; Infectious mononucleosis; Meningitis;
Pneumonia; Rashes; Sinusitis; Strep infections; Tonsillitis