Understanding and Managing Sore Throats in Children

Signs that a Sore Throat Requires Emergency Attention

Having a sore throat is a common occurrence in children and is usually nothing to be concerned about. However, there are certain signs that parents should be aware of to determine if a sore throat is a cause for alarm. If any of the following symptoms are present, immediate medical attention is recommended:

  • Trouble breathing: If your child experiences difficulty breathing, a sore throat may indicate respiratory system swelling or blockage.
  • Trouble swallowing and drooling: Difficulty swallowing accompanied by excessive drooling can be a sign of dangerous swelling or blockage.
  • High fever and unusual sleepiness: A persistent fever of 102°F or higher, unresponsive to medication, along with unusual sleepiness, may indicate a serious infection.
  • Severe and unrelenting pain: If your child experiences intense pain that persists, regardless of its location, immediate medical attention is warranted.

If any of these symptoms occur, it is important to take your child to the nearest emergency room.

Common Causes of Sore Throats in Children

Fortunately, such emergencies are rare, and most sore throats in children are caused by more common factors, including:

  • Viral infections: If your child has a runny nose, cough, body aches, fever, upset stomach, or diarrhea along with a sore throat, it is likely a viral infection, possibly even COVID-19. Contact your doctor for COVID testing, as even a lone sore throat could be a symptom.
  • Allergies: Allergies frequently result in sore throats, especially when nasal congestion leads to breathing through the mouth, causing dryness. Distinguishing between allergies and a viral infection can be challenging. If the sore throat is accompanied by a stuffy nose, sneezing, and itchy eyes, it is likely due to allergies. Consult your doctor if uncertain.
  • Bacterial infections, including strep throat: A bacterial infection is more probable when there is a fever without a runny nose or cough. Streptococcal infections, in particular, may present additional symptoms such as headaches, stomachaches, a sandpapery rash, and a muffled voice resembling someone with a hot potato in their mouth.
  • Inhaled or swallowed irritants: Environmental factors such as air pollution can cause throat irritation, as can ingesting substances that irritate the throat, like acids. Ensure your child cannot access hazardous materials and contact your doctor or Poison Center (800-222-1222) if ingestion is suspected.
  • Gastroesophageal reflux: When stomach acid regurgitates into the throat, it can result in a sore throat. If your child experiences frequent stomachaches and/or heartburn in addition to a sore throat, reflux may be the cause. Discuss this possibility with your doctor.

Preventing Sore Throats

To reduce the risk of infections leading to sore throats, it is advisable to adopt preventive measures, such as:

  • Frequent handwashing: Regularly wash hands with soap and water, or use hand sanitizer if soap is unavailable.
  • Avoid face touching: Refrain from touching the face to minimize the transfer of germs.
  • Sanitize public surfaces: Before touching public surfaces, such as doorknobs or handrails, consider wiping them down to reduce the risk of contamination.
  • Minimize contact with sick individuals: Whenever possible, avoid close contact with people who are ill to prevent the spread of infectious pathogens.

In areas where COVID-19 infections are prevalent, wearing a mask and getting vaccinated, if eligible, can significantly help reduce the likelihood of contracting the virus.

As a service to our readers, please note that this article is from our archived content. Visit our website for the latest information on this topic.

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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