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Recognizing the Warning Signs: When Your Child’s Sore Throat Demands Attention

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Sore throats are a common occurrence in childhood and are usually harmless, often accompanying a common cold. Most of the time, they resolve on their own without any treatment. However, it's essential to recognize that there are instances when a sore throat may indicate a more serious underlying problem, necessitating medical attention. Here are four examples of when a sore throat may warrant medical treatment:

Strep Throat

Strep throat is a prevalent infection caused by a specific type of bacteria called streptococcus. In addition to a sore throat, children may experience symptoms such as fever, headache, stomachache (sometimes with vomiting), and a fine, pink rash resembling sandpaper. While these symptoms may also be present in viral infections, the only way to confirm strep throat is through rapid testing and/or a culture. Although strep throat can resolve without antibiotics, we prescribe them to prevent rare complications like heart problems, kidney problems, and arthritis.

Peritonsillar or Retropharyngeal Abscess

A peritonsillar or retropharyngeal abscess refers to a collection of pus either behind the tonsils or at the back of the throat, which can be dangerous. Signs of these abscesses include redness and swelling on one side of the throat, severe sore throat accompanied by fever and neck stiffness.


Stomatitis is an ailment caused by viral infections that result in sores in the mouth and throat. While it typically resolves on its own, it can make eating and drinking extremely uncomfortable, leading to dehydration, especially in very young children. Medications are available to alleviate the discomfort caused by the sores and enable easier drinking, thus preventing dehydration.


Young children's curiosity often leads them to ingest harmful substances, such as strong acids or alkaline substances, causing burns to the mouth and throat. Common household products like bleach, drain cleaners, toilet bowl cleaners, some detergents, and even beauty products like hair straighteners can cause severe damage. If an adult was not present when the ingestion took place, they may only be aware of the child suddenly complaining of mouth and throat pain.

Recognizing When to Seek Medical Attention for Your Child's Sore Throat

While most sore throats in children can be managed at home, certain signs and symptoms necessitate contacting a doctor:

  • Difficulty breathing or any noticeable change in breathing patterns
  • Trouble swallowing, particularly if accompanied by excessive drooling
  • Stiff neck
  • A persistent high fever (102°F or higher) that does not subside with over-the-counter pain relievers or keeps recurring
  • Refusal to drink fluids or significantly reduced fluid intake
  • Severe pain (any severe pain should be evaluated by a doctor)
  • Excessive sleepiness or difficulty waking up and staying awake
  • Presence of a rash, headache, stomachache, or vomiting, which may indicate strep throat or other infections. If the child has been in contact with someone diagnosed with strep throat, any sore throat should prompt a medical appointment for further evaluation.

If none of these symptoms are present, it is likely that your child will recover within a day or two without any complications.

Helping Your Child Find Relief from Sore Throat

If your child is experiencing a sore throat, there are a few strategies you can employ to provide comfort:

  • Offer cold liquids or foods like popsicles, ice cream, or refrigerated Jell-O. If your child has a decrease in appetite, it's crucial to ensure they stay hydrated by giving small sips of fluids at frequent intervals.
  • Administer acetaminophen or ibuprofen following the recommended dosage for your child's age and weight, as advised by your doctor.
  • Avoid salty, spicy, acidic (like orange juice), or sharp (like potato chips) foods if your child has mouth sores. Stick to bland and soft foods.
  • Utilize a humidifier to keep the throat moist, which can alleviate discomfort.

Remember, if you have any questions or concerns, don't hesitate to contact your child's doctor for guidance and support.

William H. McDaniel, MD

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School.

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