Causes·    

• Colds (URIs). Most sore throats are part of a cold.  In fact, a sore throat may be the only symptom for the first 24 hours. 
• Viral pharyngitis. Some viruses cause a sore throat without nasal symptoms. 
• Strep pharyngitis. Group A Strep is the most common bacterial cause. It accounts for 20% of persistent sore throats. Only these need an antibiotic.

Strep Throat

• Symptoms include sore throat, fever, headache, stomach pain, nausea and vomiting.
• Cough, hoarseness, red eyes, and runny nose are usually not seen with Strep throat. These symptoms point more to a viral cause.
• Scarlet fever rash (fine, red, sandpaper-like rash) is highly suggestive of Strep throat.
• Peak age: 5 to 15 years old.  Not common under 2 years old unless sibling has Strep.
• Diagnosis should be confirmed by a Strep test before starting treatment. There is no risk to your child to delay treatment until a Strep test can be done.
• Standard treatment is with antibiotics by mouth.

Symptoms in Infants and Toddlers

• Children less than 2 years of age usually don't complain about a sore throat. A young child who does not want favorite foods may have a sore throat. They may also start to cry during feedings. Their symptoms are usually better covered using DRINKING FLUIDS -DECREASED guide.

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.
• Also, children with Strep throat need to be taking an antibiotic for 24 hours.

1. What You Should Know:
   • 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.
   • Here is some care advice that should help.
2. Sore Throat Pain Relief:
   • Age over 1 year. Can sip warm fluids such as chicken broth or apple juice.
   • 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.
   • Medicated throat sprays or lozenges are generally not helpful.
3. Pain Medicine:
   • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed. See Dose Table.
4. Fever:
   • For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. See Dose Table. Note: Lower fevers are important for fighting infections.
   • For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.
5. 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.
   • Solids. 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 solids.
   • Swollen tonsils can make some solid foods hard to swallow.
6. 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.
   • Also, children with Strep throat need to be taking an antibiotic for 24 hours.
7. What to Expect:
   • Most often, sore throats with a viral illness last 4 or 5 days.
8. 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
   • Your child becomes worse