Sore Throat

When To Call

Call 911 Now

• Severe trouble breathing (struggling for each breath, can barely speak or cry)
• Purple or blood-colored spots or dots on skin with fever
• You think your child has a life-threatening emergency

Go to ER Now

• Can't swallow any fluids and new onset drooling
• Purple or blood-colored spots or dots on skin without fever

Call Doctor or Seek Care Now

• Trouble breathing, but not severe
• Great trouble swallowing fluids or spit
• Can't open mouth all the way
• Stiff neck or can't move neck like normal
• Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears.
• Weak immune system. Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
• Fever higher than 104° F (40° C)
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent. Note: a Strep test alone is not urgent.

Contact Doctor Within 24 Hours

• Sore throat pain is severe and not better 2 hours after taking ibuprofen
• Large lymph nodes in the neck
• Pink rash that's widespread
• Earache or ear drainage
• Sinus pain (not just congestion) around cheekbone or eyes
• Fever lasts more than 3 days
• Fever returns after being gone more than 24 hours
• Age less than 2 years old
• Close contact to a person with Strep within last 7 days
• Sores on the skin
• You think your child needs to be seen, but the problem is not urgent (or needs a Strep test)

Contact Doctor During Office Hours

• Sore throat is the main symptom and lasts more than 48 hours
• Sore throat with cold/cough symptoms lasts more than 5 days
• You have other questions or concerns

Self Care at Home

• Viral throat infection suspected

Care Advice

What You Should Know About Sore Throats:

• Most sore throats are just part of a cold and caused by a virus.
• A cough, hoarse voice or nasal discharge points to a cold as the cause.
• Most children with a sore throat don't need to see their doctor.
• Here is some care advice that should help.

Sore Throat Pain Relief:

• Age over 1 year. Can sip warm fluids such as chicken broth or apple juice. Some children prefer cold foods such as popsicles or ice cream.
• Age over 6 years. Can also suck on hard candy or lollipops. Butterscotch seems to help.
• Age over 8 years. Can also gargle. Use warm water with a little table salt added. A liquid antacid can be added instead of salt. Use Mylanta or the store brand. No prescription is needed.
• Honey for age 1 year and older. Honey can be helpful for soothing a sore throat. Amount: offer 5 mL (1 teaspoon) as needed for pain.
• Medicated throat sprays or lozenges are generally not helpful.

Pain Medicine:

• To help with the pain, give an acetaminophen product (such as Tylenol).
• Another choice is an ibuprofen product (such as Advil).
• Use as needed.

Fever Medicine:

• For fevers higher than 102° F (39° C), give an acetaminophen product (such as Tylenol).
• Another choice is an ibuprofen product (such as Advil).
• Note: fevers less than 102° F (39° C) are important for fighting infections.
• For all fevers: keep your child well hydrated. Give lots of cold fluids.

Fluids and Soft Diet:

• Try to get your child to drink adequate fluids.
• Goal: keep your child well hydrated.
• Cold drinks, milk shakes, popsicles, slushes, and sherbet are good choices.
• Solid Foods: offer a soft diet. Also avoid foods that need much chewing. Avoid citrus, salty, or spicy foods. Note: fluid intake is much more important than eating any solid foods.
• Swollen tonsils can make some solid foods hard to swallow. Cut food into smaller pieces.

Return to School:

• Your child can return to school after the fever is gone. Your child should feel well enough to join in normal activities.
• Most often, having just a sore throat is not a reason to miss school.
• Children with Strep throat need to be taking an antibiotic for at least 12 hours.

What to Expect:

• Most often, sore throats with a viral illness last 4 or 5 days.

Call Your Doctor If:

• Sore throat is the main symptom and lasts more than 48 hours
• Sore throat with a cold lasts more than 5 days
• Fever lasts more than 3 days or goes higher than 104° F (40° C)
• You think your child needs to be seen
• Your child becomes worse

Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.

Photos

Scarlet Fever Rash

The photo shows a scarlet fever rash on the forearm.

The rash first appears as tiny red bumps on the chest and abdomen that may spread all over the body. It looks like a sunburn and feels like a rough piece of sandpaper. It lasts about 2-5 days.

Scarlet fever is a disease caused by the same bacteria that causes strep throat. A person with scarlet fever has a throat that is red and sore, often a fever and swollen glands in the neck, and a scarlet fever rash.

Source: CDC PHIL
From the CDC's Public Health Image Library (http://phil.cdc.gov), ID#5163, in the public domain.