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 in children can be acute, subacute or chronic and usually occurs as a part of the disease other than Pharynx. Etiologies can be usually classified as bacterial, Viral and Protozoal. Usually self resolving, sometimes associated with more severe disease forms. Frequently more severe forms are bacterial in pediatric age groups. 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 much historical perspective for sore throat in children.

Classification

* Sore throat can be classified into three types based on the Etiology of the disease. Those include:

• Infectious
  • Bacterial:Group A Streptococci,Staphylococcus aureus, Hemophilus influenza, gonococci, chlamydia, Mycoplasma, Treponema pallidum, Fusobacterium.
  • Viral: Adenovirus, Coxsackievirus, Enterovirus, Influenza, Parainfluenza, Epstein Barr Virus, Corona Viruses, Polio Virus, Rhino Virus.
  • Protozoal: Babesia microti, Toxoplasma gondii,- less common causes.
  • Fungal: Candida.
  • Autoimmune: Steven Johnson's syndrome, Bechet's disease, Psychotic, Kawasaki's disease, PFAPA syndrome.
• Traumatic: Kids falling with a pen, stick, or other sharp objects in the throat. Chemical exposure and irritation of the mucosa.

Another classification for sore throat in children is based on the duration of onset. It can be

• Acute
• Recurrent

Pathophysiology

• The pathophysiology is inflammation.

Causes

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

• Common causes include Viral pharyngitis,Infectious mononucleosis, Candidal infections and streptococcal pharyngitis.
• Life threatening causes include: Epiglottitis,retropharygeal abscess, Parapharyngeal abscess, Peritonsillar abscess, Diptheria, Infectious mononucleosis
• other causes include: trauma,psychogenic and autoimmune

Differentiating [disease name] from other Diseases

For further information about the differential diagnosis, click here.

Epidemiology and Demographics

• The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
• In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].

Age

• Patients of all age groups may develop [disease name].

• [Disease name] is more commonly observed among patients aged [age range] years old.
• [Disease name] is more commonly observed among [elderly patients/young patients/children].

Gender

• [Disease name] affects men and women equally.

• [Gender 1] are more commonly affected with [disease name] than [gender 2].
• The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.

Race

• There is no racial predilection for [disease name].

• [Disease name] usually affects individuals of the [race 1] race.
• [Race 2] individuals are less likely to develop [disease name].

Risk Factors

• Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].

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, they appear severely ill and may present with Dysphagia, drooling, Shortness of breath

• Physical examination may be different depending on the underlying etiology as well as pathology. Examination of the pharynx is the key Notable findings include:

• Exudative Pharyngitis, petechiae on the posterior palate, Cervical lymphadenopathy are seen in streptococcal pharyngitis.
• Thick white exudate with a membranous covering of tonsils is seen in Diptheria.
• Erythematous Pharynx with posterior cervical lymphadenopathy and hepatosplenomegaly is seen in infectious mononucleosis
• Vesicular rash on the posterior pharynx is seen in herpangia, and [[vesicular rash
• [finding 5]
• [finding 6]

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 [disease name]; the mainstay of therapy is supportive care.

• The mainstay of therapy for [disease name] 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].