Children and sore throat: why it occurs, the symptoms, how to make the diagnosis for a correct treatment

Il sore throat it can be a real constant throughout childhood, especially in the colder months.

Children often experience episodes of fever due to an infection, of viral origin (in 80 percent of cases) or bacterial, which affects the tonsils or pharynx, causing a acute pain in the part of the throat immediately adjacent to the mouth.

The cause

The main causes of sore throat are: viruswhich spread rapidly through contact with respiratory secretions or dirty hands. Among the most common viruses in children are those influenza, parainfluenza or Rhinoviruses (the common cold viruses).

As for the bacterial formsthe most relevant one, especially due to the possible consequences if not treated adequately, is that of group A beta-hemolytic streptococcus (Sbega). It is a frequent infection especially in school-age children, particularly in winter and early spring. When streptococcus also extends to the skin, with the appearance of red dots, it is called Scarlet fever.

I symptoms

Symptoms that accompany sore throat include pain and difficulty swallowing, fever (above 38.5 degrees) swollen and red tonsilswhich may have white patches or streaks of pus (known as «plaques»), petechiae (red dots), which also extend onto the palate, e lymph nodes of the neck enlarged.

It is not possible to distinguish a viral infection from a bacterial one simply by looking at the throat, since the symptoms listed above are common and overlapping in both forms. However, in viral forms, the child may also experience a cold, conjunctivitis, hoarseness and red eyes.

The diagnosis

The diagnosis must be established by pediatrician. If your sore throat is intense, accompanied by high fever, swollen lymph nodes and red spots on the roof of your mouth, in the absence of a cough or cold, your doctor will consider doing a rapid test for strep. Although rapid strep tests are available in pharmacies and online, it is best to perform them in a clinical or laboratory setting.

Why can DIY be dangerous? About 15-20% of children can be healthy carriers of streptococcus. An improperly performed rapid test may result positive in the presence, however, of a viral form. For this reason, it is best to limit yourself to performing the swab only on the advice of the professional, to avoid prolonged and unnecessary use of antibiotics.

Furthermore, the rapid test is very reliable if it is positive. If the result is negative, however, it may be necessary to supplement it with a throat swabperformed in the laboratory, the results of which are available in 48/72 hours.

In therapy

Not all sore throats require the use of antibiotics; they are only necessary in case of bacterial infection. The start of antibiotic therapy, especially if based on a throat swab rather than a rapid test, can be postponed for a few days without risk of complications. Antibiotic therapies for bacterial forms must be followed for 10 daysaccording to the correct dosage. It’s fundamental don’t interrupt administering the antibiotic ahead of time, even if the child seems well, to promote complete eradication of the bacterium and avoid relapses.

Viral forms must be treated simply with paracetamol or ibuprofen (if the child is at least 3 months old).
It is also recommended to keep the child well hydrated, especially in case of high fever, often offering water or other drinks. Gargles may be helpful.
The administration of over-the-counter medications for the management of throat pain and cough it is only recommended in children over 4 years of age and after consulting the pediatrician.

Course and return to school

Sore throat viral origin resolves spontaneously in a few days. Children can return to school as soon as their health is good, usually 24-48 hours after the resolution of fever.
In bacterial forms, children can return to the community 24-48 hours after starting antibiotic therapyprovided they are well.

December 27, 2025

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