Understanding pharyngitis among children

Update: September, 23/2019 - 08:06
Dr. Sheila. — Photo courtesy of Family Medical Practice

by Dr. Sheila*

What is pharyngitis? What is tonsillitis?

The tonsils are lymph nodes found on both sides of the oral cavity. They lead to the pharynx or back of the throat, which in turn connects the nose and mouth to the airway and stomach. A “sore” throat is due to inflammation and or infection of these 2 areas.

What causes pharyngitis and tonsillitis?

Adenovirus, Enterovirus, Herpes simplex and Epstein Barr virus cause 95% of sore throats in children below 5 and 70% of sore throats in children after 5 years old. Hence a bacterial cause is less common but if so the most likely agent is Group A Streptococcus, hence the name “Strep throat”. Viruses are transmitted from an infected person’s secretions or through contaminated surfaces and objects whereas group A strep is mostly transmitted directly from people or carriers; crowded spaces also facilitate spread of these organisms.

How is it diagnosed?

Aside from throat pain viral pharyngitis gradually presents with watery eyes, a runny nose, sneezing, hoarseness and diarrhea over a few days. Children are usually themselves until symptoms disappear in 3-5 days’ time. Bacterial pharyngitis or Strep throat on the other hand presents with sudden onset high fever, chills, headache, and abdominal pain; there may be pus on the tonsils, swollen neck nodes or a skin rash, in which case it is called Scarlet fever. A throat swab and sometimes culture may be necessary to differentiate between virus and bacteria.

What can I do at home? When should I bring to doctor?

For children who are otherwise active and eating well warm saline gargles, soft, cool foods and drinks (yogurt, plain vanilla ice cream, milkshakes and smoothies) relieve the pain and ensure adequate energy intake. Quick showers and as-needed fever medicines lower the temperature and also make the child comfortable. If you notice they are more irritable than not, prefer to sleep than play, refuse fluids and solids or develop symptoms outside those described above it is best to bring to your pediatrician for further assessment.

Are there any serious complications?

Most viral pharyngitis cases resolve without sequelae. And as long as antibiotics were judiciously used in the past, bacterial pharyngitis can be simply treated as well. Recurrent and improperly treated Strep throat sometimes lead to peritonsillar abscess, rheumatic fever and nephritis. To avoid this bring your child to the clinic on the 3rd to the 5th day of illness for an appropriate doctor-prescribed treatment regimen. — Family Medical Practice


1. Canadian Family Physician Le Médecin de famille canadien Vol 53: November 2007

2. Pediatrics in Review Vol. 32 No. 11 November 2011

*After the medical boards Dr. Sheila spent a year in the US, dabbled in Internal Medicine, Dermatology and Pathology before finally specializing in Pediatrics. The cumulative experience with medical school at the UERM and internship at the Medical City General Hospital, proved indelible.

In the last year of training she was sole resident, topped consortium exams and hospital-wide research competitions. Infectious disease, Preventive Health, Pediatric nutrition, development and behavior, Counseling and Child psychology are her main interests.

She finds Vietnam intriguing and the food amazing. Fluent in English and Tagalog, she is passionate about life, motherhood, music, film, and the written word.

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