Viral sore throat or strep throat
Viral pharyngitis and tonsillitis are usually accompanied by a runny nose, cough, hoarseness and redness of the eyes - these signs are usually not present with streptococcal sore throat. Streptococcal infection is more common in children 5–15 years old and begins abruptly, with high fever, severe pain when swallowing, plaque on the tonsils and painful lymph nodes under the jaw. Streptococcal sore throat is rare in children under three years of age. Ultimately, the issue is decided not by the appearance of the throat, but by the test for streptococcus.
- Cough, runny nose, hoarseness, conjunctivitis indicate a virus.
- For streptococcus - an abrupt onset without cough or runny nose
- Plaque in itself does not prove bacterial nature
- Peak streptococcal sore throat is age 5–15 years
- Confirmation - rapid test or throat culture
Symptoms
The child complains of a sore throat that gets worse when swallowing, refuses to eat, and becomes lethargic. The temperature often rises above 38 °C, and the lymph nodes in the neck become enlarged and painful. The tonsils appear enlarged and red and may have white spots or plaque on them. Babies who do not yet complain about their throat simply refuse to eat, cry and sleep worse. Sometimes abdominal pain, nausea and headache occur.
- Sore throat when swallowing
- Temperature above 38 °C
- Plaque or white spots on the tonsils
- Enlarged, painful lymph nodes in the neck
- Refusal to eat and drink
- Headache and stomach pain
Diagnostics
The doctor examines the throat, feels the lymph nodes and assesses the general condition. The key test is a smear from the tonsils: a quick rapid test for streptococcus gives results in a few minutes, culture for flora is more accurate, but takes time. A general blood test helps assess the severity of inflammation and suspect infectious mononucleosis, which often disguises itself as a sore throat. Analysis for ASLO in the acute period is not needed; it is used later, if rheumatic complications are suspected.
- Examination of the pharynx and cervical lymph nodes
- Rapid test for group A streptococcus
- Throat culture for microflora
- General blood test
- ASLO - only for special indications
- Examination by an ENT doctor for unilateral edema
Treatment
For viral sore throat, treatment is symptomatic: plenty of warm fluids, soft, non-irritating food, antipyretics and painkillers in an age-appropriate dose. If streptococcal sore throat is confirmed, an antibiotic is prescribed, and it is extremely important to take the full course, even if the child feels better after two days: an untreated infection is dangerous due to late complications. Rinses and sprays relieve symptoms, but do not replace the antibiotic. For young children, sprays are used with caution and only on the recommendation of a doctor.
- Drink plenty of fluids and eat bland food
- Antipyretic and analgesic according to age
- Full course antibiotic for streptococcus
- Warm saline rinses for older children
- Bed rest on fever days
- Separate dishes to avoid infecting loved ones
Complications and frequent sore throats
Early complications are associated with the spread of pus: a peritonsillar abscess is manifested by increased pain on one side, difficulty opening the mouth and a muffled voice and requires urgent help from an ENT doctor. Late complications of streptococcal infection are acute rheumatic fever with damage to the heart and joints and post-streptococcal glomerulonephritis; It is for the sake of their prevention that a full course of antibiotics is needed. If tonsillitis recurs frequently and significantly disrupts the child’s life, removal of the tonsils is discussed with the ENT doctor.
- Peritonsillar abscess
- Cervical lymphadenitis
- Otitis media
- Acute rheumatic fever
- Glomerulonephritis
- Discussion of tonsillectomy for frequent exacerbations
