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The Informed Parent

Sore Throats In Children

by Louis P. Theriot, M.D., F.A.A.P.
Published on Apr. 26, 1997

It is bedtime, and your 5 year old says that she doesn't feel well and that her throat hurts. You take her temperature and find that she has a fever. As you look down her throat with a flashlight, you see the problem. Her throat is fiery red, and she has pus pockets on her tonsils. With your worst fears confirmed, "tonsillitis", you are in a real quandary. What to do?! Should you A) wait it out, B) rush her to the emergency room, or C) give her some left over antibiotics that you have stored somewhere in the medicine cabinet?

Parents are confronted with this dilemma quite often. "Tonsillitis" seems to strike fear in the minds of parents, far worse than it really is. They even say it with a hesitance as if it were a dirty word.

Tonsillo-pharyngitis refers to an infection, or inflammation, of the throat and tonsils...and they usually occur together. The causes are many, and include a host of different viruses and a myriad of bacteria. The usual symptoms include a fever and sore throat. There may be an associated headache, stomachache, swollen and tender lymph nodes in the neck and possibly a rash. It is virtually impossible on a physical exam to distinguish which infection is caused by a virus or by a bacteria.

All cases of tonsillo-pharyngitis, including strep throat, will resolve completely in a matter of days (even without antibiotics).

Strep throat refers to a tonsillitis that is caused by one specific type of bacteria, the group A streptococcus. What makes strep stand out is it's ability to cause secondary problems long after the sore throat has cleared up. These complications include an inflammation of the kidneys, damage to the valves of the heart, or more seriously, rheumatic fever. These problems may not show up for months.

When the doctor puts a patient on an antibiotic for strep throat, it is to eradicate the strep and thus prevent these complications from occurring. The sore throat will go away in time, with or without therapy.

We are so fortunate these days to have the ability to diagnose strep with relative ease. A throat culture can be done, and this takes a day or two for an answer. There are a number of "rapid" strep tests that can give an answer within 10 minutes.

The treatment of strep is made simple with a virtual arsenal of antibiotics to chose from...all of which are very effective in eradicating the infecting bacteria.

To get back the scenario that we started with regarding the 5 year old with a sore throat, I surely would not have picked A, B, or C. A more correct response would have been D) to give her something for her fever, be sure she drank plenty of fluids, and call her doctor to discuss appropriate therapy.

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