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Causes of Sore Throat in Kids Including Viral Pharyngitis and Strep Throat

Infectious Diseases

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Let’s Explore Causes and Prevention of Sore Throat

Is your kid not eating and drinking? What can be the possible reason? Perhaps your child has a sore throat from a virus or strep throat.  Sore throat is medically known as “pharyngitis. This is the inflammation of the pharynx. Usually, we see viral pharyngitis or sore throat caused by viral infections. Other times we see pharyngitis as a result of a bacterial infection like strep.


Causes of Sore Throat

Various reasons are associated with a sore throat in kids. Here are the most common ones:

  • Viral infections – include the common cold and influenza. Remember, most sore throats are caused by viral infections.
  • Bacterial infections- bacterial infections are less likely to cause sore throat compared to viral infections. The most common bacterial infection that causes pain in the throat is streptococcus. Streptococcal pharyngitis is commonly known as “strep throat’. This bacteria causes more than 600 million cases of acute pharyngitis around the world each year!
  • Dry mouth and postnasal drip can also cause sore throat in kids.
  • Allergies sometimes cause sore throat in kids.
  • Gastroesophageal reflux disease can cause sore throat in kids.


Symptoms of Sore Throat

Common signs and symptoms of sore throat include the following:

  1. Dysphagia- Difficulty swallowing food or even liquid
  2. Sensation of pain
  3. Redness can be seen in the back of the mouth.
  4. Runny nose, cough, and congestion (it is usually due to a viral infection).
  5. Your child may experience vomiting, nausea, and abdominal cramps (usually, this happens due to strep).
  6. Swollen lymph nodes in the neck.


How to tell if a sore throat is from a viral infection or bacterial pharyngitis:

Both viral and bacterial infections can cause sore throats. It helps to have an exact way to tell whether throat pain is from a common bacterial infection or viral illness.


Viral upper respiratory tract infections

  • Redness of the throat due to inflammation
  • Cough is present
  • Runny nose

NOTE: Viruses cause almost 95% sore throats in children younger than five years.


Strep Symptoms

  • Vomiting and nausea
  • Headache
  • Stomach ache
  • Rash on the chest called Scarlet Fever
  • Flu-like symptoms
  • Muscle strain and achiness


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Treatment for sore throats

If your child has viral pharyngitis, treatment involves lots of fluids, rest, and honey for children over the age of one. Some doctors prescribe anti-inflammatory drugs like ibuprofen for pain, swollen glands, and fever relief. Acetaminophen can be used to control fever and relieve symptoms as well. Warm, soothing fluids can help, too, like tea or broth. Uncomplicated pharyngitis does not require specific treatment, lasts only a few days, and management is with symptomatic treatment alone. Please seek medical care from your health care provider if your child is taking anti-inflammatory medicine for persistent pain or worsening symptoms.


Treatment for Strep Throat

On the other hand, bacterial sore throat is managed with the help of antibiotics. See your doctor if you think your child has strep throat. Antibiotics will be prescribed if the swab is positive for streptococcal pharyngitis. Your child will also benefit from pain medicine, rest, and plenty of fluids, as in the case of viral pharyngitis. Remember, antibiotics are only helpful in strep throat and other bacterial infections and help prevent strep throat complications such as Scarlet Fever and Rheumatic Fever. Antibiotics don’t work in viral infections as viruses don’t respond to antibiotics.



Seek medical attention from a registered medical practitioner when your child has the following signs and symptoms:

  1. Difficulty in breathing
  2. Dysphagia – problems eating and difficulty swallowing
  3. High fever or persistent fever > 3 days
  4. If your child is less than six months of age
  5. Severe vomiting
  6. Neck stiffness
  7. Decreased level of consciousness


F.A.Q. – Frequently Asked Questions

What kind of medicine shall I give to my kid with a sore throat?

Try giving your kid a soft diet. Avoid acidic, salty, and spicy food items. It is better to provide honey and warm soup to soothe their throat.


Can I give antibiotics to my kid with a sore throat? 

It would help if you were sure of the diagnosis first. Whether this sore throat is due to bacteria or viruses determines the best treatment options. Don’t use antibiotics if your kid has a viral sore throat. Misuse of antibiotics can lead to antibiotic resistance and other harmful complications. On the other hand, if your child has a confirmed strep infection, we prescribe antibiotics to decrease the risk of rheumatic fever and other complications of group a streptococcus infection.


Does honey work in the viral sore throat?

Yes, it does. Honey has antiviral properties and soothes the throat. However, DO NOT give honey to a baby less than one year of age due to the risk of botulism.


Can mononucleosis cause sore throat in children?

Yes, infectious mononucleosis is also a common cause of sore throat in children. It is a viral infection caused by Epstein Barr Virus. It presents like strep, with symptoms of pharyngitis, muscle aches, fatigue, and sore throat. A throat culture will rule out a diagnosis group A streptococcus, and a mono test can demonstrate a mono infection.



Dr Dina Kulik - Kids Health

Dr. Dina Kulik, MD, FRCPC, PEM

Written By: Dr. Dina Kulik, MD, FRCPC, PEM

Dina is a wife, mother of 4, and adrenaline junky. She loves to share children’s health information from her professional and personal experience. More About Dr Dina.

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