Older children with throat pain often complain of swallowing. Young children with sore throats are usually crabby, refuse to eat, or grab their tongues. Sore throats may have redness, swelling, or white spots on the tonsils. These children usually have “swollen glands” or inflammation of lymph nodes under the chin. These swollen lymph nodes sometimes cause pain in the front of the neck.
Throat pain has many causes:
- Irritation may cause pain or inflammation in the throat. Causes include yelling, post nasal drainage (ex. allergies), frequent coughing or throat clearing.
- Sores or lesions in the mouth may cause sore throats. Check your child’s mouth for canker sores, sores on the palate, or irritation from accidentally biting his cheeks.
- Viruses cause most sore throats. These children usually have cold symptoms, such as runny nose, coughing, hoarse voice, and fevers.
- About 10% of sore throats are caused by bacteria, such as strep. Unfortunately, examination of the mouth, throat, and neck is not totally reliable, and a strep test and culture need to be done during office hours to correctly diagnose and treat strep throat. Strep throat rarely affects children younger than school age. Usually strep throat is associated with fever, feeling tired or achy, swollen glands in the front of the neck, stomach aches, and a red/irritated throat. Sometimes a child with strep will also get a classic rash: a sandpaper-like feel of tiny red bumps on the trunk and face that spares the mouth; the tongue can look like a strawberry – bright red with white dots. Strep associated with this rash is called Scarlet Fever. It is no more worrisome than strep throat, but still needs antibiotic treatment. The sore throat of strep will improve without treatment, but it is imperative to treat strep throat with a full course of antibiotics to prevent complications that can hurt your heart (rheumatic fever) or kidneys.
- Mono or mononucleosis is a viral cause of sore throats. Mono is spread by saliva (sharing sips of fluids, bites of foods, kissing, etc.) and typically affects adolescents or older children. Mono is associated with extreme fatigue, fever, muscle aches, posterior lymph node swelling, stomach aches and painful, irritated throat. Mono is diagnosed by blood test. While there is no specific treatment for mono, it is important to be diagnosed for explanation and reassurance of ongoing illness. Children with mono may return to school/work when they are fever free but should refrain for high contact activities if they have enlarged spleens.
WHAT TO DO:
Tylenol or Motrin may help alleviate throat pain. Drinking sips of fluids or standing in a shower may alleviate irritation of the throat. Some children prefer ice chips or popsicles; others prefer warm beverages. Gargling may help alleviate mucous irritation of the throat. Throat lozenges or just hard candy may be soothing to older children.
WHEN TO CALL:
Call during office hours if your child has a sore throat, especially without cold symptoms. Often the nurse may schedule a visit to obtain a throat culture. Please call during office hours if a sore throat is worsening or not improving over the course of a week, or if your child is unable to stay hydrated.