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Sore throats are one of the most common complaints seen in a pediatric office, but did you know your doctor cannot simply look in your child’s mouth and tell whether the sore throat is caused by a virus or a bacteria? In fact, a recent study published by the American Academy of Pediatrics (AAP) confirms that clinical symptoms are not reliable in diagnosing strep throat. In other words, not all sore throats are the same.

Typically, sore throats are either caused by a viral or bacterial infection. There are numerous viruses that cause sore throats in children, including the common rhinovirus. Many times, viral sore throats will be accompanied by congestion, runny nose, cough, and fever. Sore throats caused by a virus are not treated with antibiotics, and symptoms usually go away on their own within several days.

Sore throats can also be caused by a bacterial infection, most commonly by the Strep pyogenes organism, or Group A Strep. Strep throat can be accompanied by fever, vomiting, and abdominal pain, but it is not usually associated with upper respiratory symptoms. Often, the back of the throat will be very red with dots or streaks on the palate. The tonsils may also be covered in a white coating and the tongue may look like a strawberry.

If your child has a sore throat that does not improve within 24 hours, he or she should be evaluated. The pediatrician will likely order a throat swab to test for the presence of a strep infection. The rapid strep test can be performed in the office and is a quick and fairly reliable method to detect the presence of the bacteria. A throat culture can also be sent, although the results take two days to become available.

If the throat swab is negative, your child likely has a viral infection that will resolve on its own. If your child tests positive for strep, however, he or she will need a prescription antibiotic to clear the infection and prevent further complications. Pain relievers such as acetaminophen or ibuprofen can be given to help alleviate symptoms, as well as cool or warm liquids to soothe the throat.

Reviewed by Dr. Sara Connolly, February 2019

Takeaways

  • Not all sore throats are treated the same way.
  • Viral sore throats usually accompany congestion, runny nose, cough, and fever.
  • The rapid strep test can show if your child has Group A strep.
  • Over-the-counter medications, like acetaminophen or ibuprofen, can help alleviate symptoms.

References

  1. American Academy of Pediatrics. Clinical symptoms not reliable in diagnosing strep throat.
  2. American Family Physician. Diagnosis and Treatment of Streptococcal Pharyngitis.
  3. Up to Date. Treatment and Prevention of Streptococcal tonsillopharyngitis.

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