THE BALTIMORE JEWISH HOME
MARCH 22, 2018
Health & F tness
Sore Throat, Strep Throat and Tonsillitis By Hylton I. Lightman, MD, DCH (SA), FAAP
B A LT I M O R E J E W I S H H O M E . C O M
OCTOBER 29, 2015 | The Jewish Home
t’s no revelation that nasty sore throats are a part of kids and life. It can happen a lot, especially once your child begins attending play group or school. After all, sharing germs is part of growing up. And sharing germs has its good points but that’s for another time. Sore throats happen even to doctors’ kids; one of our own is suffering from one at this moment (and the strep tests were negative). But not all sore throats mean a strep throat. It’s hard to sort through when medical intervention is needed and when it’s not needed. It’s exacerbated because the terms tonsillitis, strep throat, and sore throat are used interchangeably. How’s a parent to sort through all this? Tonsillitis refers to tonsils that are inflamed. Signs of tonsillitis include a sore throat, red or swollen tonsils, a yellow or white coating over the tonsils, uncomfortable or painful swallowing, swollen lymph nodes in the neck, or a fever. They can become enlarged out of nowhere and shrink without treatment. Often, the lymph nodes can remain enlarged for a longer period. When it comes to sore throats, the most frequent cause is a viral infection. When a virus is responsible, no specific medicine is required
(not good news for moms and dads who beg for prescriptions). Antibiotics work for bacterial infections, not viral ones. Allow about 7-10 days for your child to get better. It’s not uncommon for a viral sore throat to be accompanied by a cold and, possibly, a mild fever. Generally, they aren’t too sick but they can eat your heart out. Be sure they hydrate well and get extra rest. Coxsackie is a virus seen most
virus have few or no symptoms. Strep throat is caused by GAS – Group A streptococcus. In some measure, the symptoms of strep throat depend on the child’s age. • Infants and toddler may have a low fever and a thickened or bloody nasal discharge. These children are generally cranky, lack appetite and have swollen neck glands. Some toddlers complain of tummy aches rather than sore throats.
Left untreated, the infection may worsen or spread to other parts of the body.
often during the summer and fall months. It may cause a slightly higher fever in a child, as well as more difficulty swallowing and a sicker overall feeling. Coxsackie infection can also be accompanied by blisters in the throat and on the hands and feet (which is why it’s also known as Hand, Foot and Mouth Disease). Mono, or infectious mononucleosis, can cause a sore throat together with tonsillitis. Most young children who are infected with the mononucleosis
• Children ages 3+ years are often more ill and have extremely painful throats, fevers over 102 degrees Fahrenheit (38.9 Celsius), swollen neck glands, and pus on the tonsils. It’s important to differentiate between sore throats and strep throats because the latter are treated with antibiotics. How is strep throat diagnosed? If your child has a sore throat that persists (meaning one that does
not go away after his first drink in the morning), you should call your pediatrician. This means you should call even if there’s no accompanying fever, headache, stomachache, or extreme fatigue. It’s a more urgent call to the pediatrician of your child seems quite ill as demonstrated by drooling or difficulty breathing. It is not a dire emergency to go to an urgent care for a throat culture in the middle of the night except if, as mentioned, drooling and difficulty swallowing are issues. A peritonsillar abscess has to be excluded in those situations. Your pediatrician will examine your child and may perform a throat culture to determine the source of infection. Most pediatric offices perform rapid strep tests that provide results within minutes. If it’s negative, it is presumed to be viral and antibiotics are not needed. Some pediatric offices will do a dual strep culture, meaning cotton-tipped applicators touch the throat and tonsils simultaneously so if the rapid test is negative, the tip of the other applicator is smeared onto a special throat culture dish that allows strep bacteria to grow if they are present. The culture dish is usually examined 24 hours later to see if bacteria has grown. Strep throat is treated with an-
Baltimore Jewish Home - 3-22-18