Sore throat in children

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Synonyms and Keywords: Sore throat in kids

Overview

Sore throat is an infection of the respiratory mucosa of the throat.It is most commonly felt as a sensation of pain in the pharynx. In children it can be classified as acute, subacute or recurrent. Common etiologies include bacterial, Viral and Protozoal organisms. It is usually self resolving, but can be associated with more severe disease forms. Treatment in general is conservative, however Antibiotics and Antivirals can be used depending on the Etiology, and severity of clinical presentation.


Historical Perspective

There is no data available regarding historical perspective for sore throat in children.

Classification

  • Sore throat can be classified into Infectious and Non infectious causes based on the etiology.[1]

Infectious

Non Infectious

Pathophysiology

Sore throat is the most common initial symptom of an upper respiratory tract infection. It is commonly described as a painful sensation in the throat. Inflammation by viral and bacterial pathogens releases prostaglandins and bradykinin which irritate the sensory nerve endings in the throat. This sensation of pain is mediated to the brain by the cranial nerves supplying the hypopharynx and nasopharynx.[2]

Causes

Sore throat in children can be acutely life-threatening or from common causes.[3]

Bacteria

Viruses

Differentiating Sore throat in children from other Diseases

Sore throat is a symptom and can be seen in many varieties of diseases as an initial complaint of presentation. For an algorithmic approach to sore throat, click here.

Epidemiology and Demographics

  • One-third of children aged 5–12 years have an episode of acute sore throat annually according to data in Melbourne [4]

Risk Factors

Natural History, Complications and Prognosis

  • The majority of patients with Sore throat acquire it as a course of the respiratory tract or oropharyngeal infections remain asymptomatic for [duration/years].
  • Early clinical features include pain in the throat, itching, discomfort while more severe forms include difficulty swallowing, difficulty breathing.
  • These symptoms are usually accompanied by fever, myalgias, arthralgias, cough depending on the type of infection.
  • Common complications if left untreated in infectious conditions include Retropharyngeal abscess, Parapharyngeal abscess, Quinsy, Sepsis.
  • Prognosis is generally excellent and when identified early in acute conditions, minimal to no complications occur. However sore throat is one of the most common complaints and can be relieved by symptomatic treatment if viral.

Diagnosis

Diagnostic Criteria

  • The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
  • [criterion 1]
  • [criterion 2]
  • [criterion 3]
  • [criterion 4]

Symptoms

  • [Disease name] is usually asymptomatic.
  • Symptoms of [disease name] may include the following:
  • [symptom 1]
  • [symptom 2]
  • [symptom 3]
  • [symptom 4]
  • [symptom 5]
  • [symptom 6]

Physical Examination

  • Patients with Sore throat usually appear normal in common infections.
In life-threatening conditions, the patients appear severely ill.
  • Physical examination may be different depending on the underlying etiology as well as pathology. Examination of the pharynx is the key. However comprehensive examination gives hints for possible etiologies. Notable findings include:

Laboratory Findings

  • There are no specific laboratory findings associated with [disease name].
  • A [positive/negative] [test name] is diagnostic of [disease name].
  • An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
  • Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Electrocardiogram

There are no ECG findings associated with [disease name].

OR

An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

X-ray

There are no x-ray findings associated with [disease name].

OR

An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

Echocardiography or Ultrasound

There are no echocardiography/ultrasound findings associated with [disease name].

OR

Echocardiography/ultrasound may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no echocardiography/ultrasound findings associated with [disease name]. However, an echocardiography/ultrasound may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

CT scan

There are no CT scan findings associated with [disease name].

OR

[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

MRI

There are no MRI findings associated with [disease name].

OR

[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no MRI findings associated with [disease name]. However, an MRI may be helpful in the diagnosis of complications of [disease name], which include [complications 1], [complication 2], and [complication 3].

Other Imaging Findings

There are no other imaging findings associated with [disease name].

OR

[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

  • [Disease name] may also be diagnosed using [diagnostic study name].
  • Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy


  • There is no treatment for Sore throat in children; the mainstay of therapy is supportive care and systemic analgesia.
  • The mainstay of therapy for is [medical therapy 1] and [medical therapy 2].
  • [Medical therapy 1] acts by [mechanism of action 1].
  • Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].

Surgery

  • Surgery is the mainstay of therapy for [disease name].
  • [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
  • [Surgical procedure] can only be performed for patients with [disease stage] [disease name].

Prevention

  • There are no primary preventive measures available for [disease name].
  • Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
  • Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].

References

  1. Kenealy T (March 2014). "Sore throat". BMJ Clin Evid. 2014. PMC 3948435. PMID 24589314.
  2. Tran, Jennifer; Danchin, Margie; Pirotta, Marie; Steer, Andrew C (2018). "Management of sore throat in primary care". Australian Journal of General Practice. 47 (7): 485–489. doi:10.31128/AJGP-11-17-4393.
  3. "jamanetwork.com".