Throat infections: pharyngitis, tonsillitis, and streptococcus

Symptoms

• Sore throat
• Trouble swallowing
• Fever
• Tonsils that are swollen and red, or coated in a white, greyish, or yellowish film
• Swollen lymph nodes
• Possible cold symptoms (cough, stuffy nose, or runny nose)
• Possible nausea, vomiting, stomach ache, and headache

• Is being treated with antibiotics for a streptococcal infection, but there’s no improvement after 1 or 2 days; during this appointment, the doctor may check for a tonsillar abscess
• Has a high fever (40°C / 104°F or higher), joint pain, skin rash, or difficulty breathing
• Has dark brown urine

What is inflammation of the throat?

Pharyngitis and tonsillitis

Sore throats are usually caused by an infection in the back of the throat, called pharyngitis. If the infection spreads to the tonsils, it’s called tonsillitis.

In most cases, pharyngitis and tonsillitis are caused by an upper respiratory virus, such as the common cold or the flu.

Streptococcal infection

Sometimes, throat inflammation is caused by a bacterium. These are called streptococcal infections.

Most of the time, children with a streptococcal infection don’t have any cold symptoms, but they may complain of stomach aches and headaches. Symptoms usually come on suddenly and are accompanied by a high fever (39°C to 40°C) that does not subside with fever-reducing medication.

A streptococcal infection is relatively harmless. However, it must be treated promptly to prevent complications, reduce the duration of the disease, alleviate symptoms, and keep the infection from spreading.

Treatment

Viral pharyngitis and tonsillitis do not require any particular medical treatment. If your child has a fever, you can give them acetaminophen to ease their discomfort.

A streptococcal infection, however, must be treated with antibiotics. Antibiotic treatment can shorten the duration of a streptococcal infection, prevent complications, and limit its spread.

It’s very important to complete the full course of the prescribed medication, even if symptoms have subsided. Stopping early can lead to a relapse, cause complications, and lead to antibiotic resistance.

If your child has recurrent tonsillitis or experiences medical complications, their doctor may recommend surgery to remove their tonsils.

Care and practical advice

• To alleviate fever or aches, give your child acetaminophen (Tylenol^®, Tempra^®, etc.) or ibuprofen (Advil^®, Motrin^®, etc.) as directed, according to the recommended dose for their weight and age. Don’t give ibuprofen to babies under 6 months, and never give Aspirin^® (acetylsalicylic acid) to a child or teenager.
• Give your child plenty of liquids such as water and apple or grape juice. Avoid citrus juices (orange, lemon, grapefruit), as they could irritate your child’s throat. You can also offer them soft, soothing foods such as ice cream or yogurt.
• You can give your child a spoonful of honey before bedtime. Some studies suggest that honey may help sooth a sore throat. However, you should never give honey to children under 1, as there is a risk of infantile botulism, a rare but potentially serious illness.
• If your child is 4 or older, you can give them sugar-free hard candies and lozenges containing honey, herbs, or pectin.
• If your child is able to gargle without choking, have them to do so a few times a day with 2.5 mL (½ tsp) of salt diluted in a glass of lukewarm water.
• Encourage quiet activities. You don’t have to keep your child in bed all day, but they do need rest.

Prevention

Follow these hygiene guidelines to reduce the risk of your child contracting pharyngitis, tonsillitis, or a streptococcal infection:

• Wash your hands with soap after coming into contact with an infected person or after touching an object that they handled. Wash your child’s hands often and teach them how to do it themself as soon as possible, especially after they cough, sneeze, or blow their nose.
• Teach your child to cough or sneeze into a tissue or, if they don’t have one, into the crook of their elbow instead of into their hand.
• Clean toys, faucets, and door handles thoroughly, preferably with an alcohol-based cleaner.

Scientific review: Dr. Anne-Claude Bernard-Bonnin, pediatrician Research and copywriting:The Naître et grandir team Updated: April 2024

Photo: iStock.com/naumoid