Sore throats are usually caused by a virus. Antibiotics won’t cure a virus, but symptomatic treatment may help. (see treatment).
Sometimes a sore throat is caused by bacteria called Beta Hemolytic Streptococcus Group A. This is called “strep throat”. Strep throat is usually present with a fever greater than 101 degrees orally or 100.5 degrees axillary (under the arm), headache, fatigue, loss of appetite, red throat with or without white blotches and swollen glands. This infection rarely occurs in children less than 2 years of age.
Since most sore throats look the same, the fastest way to check for a “strep throat” is to do a “strep screen”. The strep screen is a 5 minute test that is performed in the office. If the screen is negative, we will send a throat culture. If the strep screen is positive, an antibiotic may be prescribed at that time. Occasionally based on symptoms, exam and exposure, an antibiotic may be prescribed while the throat culture is pending even if the screen is negative.
A throat culture is more sensitive to picking up Beta Hemolytic Streptococcus Group A than the screen though the strep screen in accurate 90% of the time or more. If the screen is negative, a throat culture will be sent and read by the lab in 48 hours. If the culture is positive, you will be called and an antibiotic will be given at that time.
Occasionally, adolescents develop a unique viral infection called Mononucleosis. This manifests as an extremely painful sore throat, severe fatigue (often sleeping 12-15 hours a day), and glands in the neck are often very big. The liver and spleen can sometimes be enlarged. This almost always requires very close contact with another adolescent that has Mononucleosis. Some of you may know this by the term, “The Kissing Disease” which exemplifies the close contact. This infection usually requires only supportive treatment for a sore throat; antibiotics do not help. Occasionally, short term steroids are prescribed after the patient has been examined.
Treatment for Sore Throat
- Take Ibuprofen (preferred) or Acetaminophen (See tables under Fever) as directed to relieve pain and/or fever.
- Drink plenty of fluids.
- If older than 5 years, the child may have throat lozenges or lifesavers for symptomatic relief.
- Humidified air—try a vaporizer or humidifier.
Call the office if…
- The sore throat last more than 3 days.
- Persistent fever with sore throat for > 24 hours.
- Sibling or close friend diagnosed with strep throat within the last week.
- Pain occurs with just opening the mouth.
- Unable to drink.
- Large painful glands in the neck below angle of the jaw.
- On antibiotics and the sore throat symptoms are not better in 3 days.
If your child has been diagnosed with strep throat…
- “Strep Throat” is contagious until the patient has taken antibiotics for 24 hours. The child can return to school after an antibiotic have been taken for 24 hours and does not have a fever.
- In most cases, the patient will feel well after a day or two. It is important that the patient continues the medication as prescribed for the full course even if symptoms disappear.
- To protect others in the family, precautions must be followed to make sure they have no contact with the bacteria from the child’s sputum or discharge from the nose. This includes no sharing cups, drinks or food, and no kissing for 48 hours after starting the medicine. Call my office, if other siblings develop symptoms. Do not give medication intended for this patient to another family member! Although strep throat is contagious, other family members will not necessarily get it. Some people are quite resistant to the bacteria. It is best to keep an eye on them and call if any symptoms develop.