Doctors Notes:

Sore Throat (Pharyngitis)

Carrita Plaskewicz

Sore Throat (Pharyngitis)

Now that winter is in full swing, so are colds and sore throats. This article will focus on helping you care for your child with a sore throat and know when to call the office and seek treatment.  Most sore throats are part of a cold and therefore are caused by viruses. The presence of a cough, hoarseness, or nasal symptoms usually means a viral infection as the cause of your child’s sore throat.  Most sore throats with a viral illness usually last 4-5 days. 20% of severe sore throats are caused by strep bacteria.


A sore throat, known as pharyngitis, involves pain, discomfort, or a raw feeling in the throat, especially with swallowing. Children under age 2 usually are unable to complain about a sore throat and may refuse to eat or drink or cry during feedings.

  • Swollen, tender glands in the neck
  • Difficulty swallowing
  • Fever
  • Headache
  • Stuffy or runny nose and sneezing
  • Mild Cough
  • Congestion

Most cases of pharyngitis, especially those caused by viruses, are treatable with rest, drinking plenty of fluids, and using over-the-counter pain medicine if needed. Cold drinks and milk shakes are good too!  You may give your child Acetaminophen (Tylenol) or Ibuprofen (over 6 months of age) for throat pain.  These may also be given for a fever above 102.

Here are a few other options for your child:

  • Age over 6 months: Sip warm apple juice
  • Age over 6 years: Suck on hard candy or lozenges.
  • Age over 8 Years: Gargle with warm water and add a little table salt.

Pharyngitis caused by strep throat is treated with an antibiotic.

Pharyngitis caused by a virus does not respond to antibiotics.

Your child may return to day care or school after the fever is gone and your child feels well enough to participate in normal activities. If your child has been diagnosed with Strep Throat, they may return to school/day care after being on antibiotics for 24 hours.

When to Call the Office
 Great difficulty swallowing fluids or saliva.
 Difficulty breathing or stiff neck.
 Inability to open the mouth completely.
 A fever that exceeds 105ºF.
 Signs of dehydration (very dry mouth, no tears with crying, and no urine for more than 8 hours).
 Severe throat pain.
 Rash that is widespread and/or spreading.
 An ear ache.
 A sore throat that lasts longer than 24 hours, when the sore throat is the main (or only) symptom.
 A sore throat with cough/cold symptoms that is present for more than 3 days.
 Your child’s symptoms become worse.
Go to Emergency Department if:
Drooling or spitting out saliva because your child can’t swallow
Call 911 if:
Severe difficulty breathing (struggling for each breath, making grunting noises with each breath, unable
to speak or cry because of difficulty breathing, severe chest retractions).

Key points about pharyngitis in children
 Pharyngitis is inflammation of the throat.
 Viruses are the most common cause. They do not require antibiotics for treatment.
 If bacteria are NOT the cause of the infection, treatment is focused on the comfort of your child.
 If your child is diagnosed with Strep Throat (bacterial infection), they will be prescribed antibiotics and are contagious for 24 hours after starting antibiotics.
 If your child’s sore throat is severe and includes difficulty swallowing or breathing, drooling, stiff neck, or neck swelling, call 911 or your local emergency number.