Red throat and high fever in a child: causes, what to do and how to treat?

Red throat and high temperature in a child is a frequent pathology that parents encounter, no matter what age the child is. But not always such a pathology should be treated with antibiotics. It is necessary to figure out when parents can treat red throat themselves, and when exactly you need to see a doctor.

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Causes of the red throat with fever

About 10 percent of children who go to the doctor every year have pharyngitis. Forty percent of cases when children go to the doctor with a sore throat, a sore throat is diagnosed as viral. Therefore, speaking of the causes, you need to figure out when to think about viral etiology, and when about bacterial.

All throat infections are transmitted through saliva, either by coughing or by contact with bacteria or viruses on the hands of an infected person or personal items. The incubation period (the time from when you associate with the disease to the time when you feel pain) is between 2 and 5 days. The incubation period for viral causes of sore throat in children varies from 3 days to 2 weeks.

Of course, the most common cause of sore throat in children is any of a large number of viruses. These viruses can cause severe fever and a very sore throat. Colds and flu are major causes. These viruses cause inflammation in the throat, and sometimes inflammation of the tonsils (tonsillitis). The flu virus can cause sore throat in addition to its many other symptoms. A flu cough can also irritate the throat, and therefore pain can occur.

Coxsackie virus (a disease of the hands, feet, and mouth) is a virus that causes severe fever and painful sores on the throat, cheek, gums, or lips. This virus can cause a disease called herpangina. Although any child can get herpangina, it is most common in children under 10 years of age and is more common in the summer or early fall.

Another group of viruses that causes sore throat is adenoviruses. They can also cause infections of the lungs and ears. In addition to sore throat, symptoms accompanying adenovirus infection include cough, runny nose, white bumps on the tonsils and throat, mild diarrhea, vomiting, and rash. Painful throat lasts about a week.

Three to six days after contact with the Coxsackie virus, an infected child develops a sudden inflammation of the throat, which is accompanied by significant fever, usually in the range of 38.9-40 ° C. Tiny grayish-white blisters are formed on the throat and mouth. They fester and become small ulcers. Sore throat is often severe, preventing swallowing. Children may become dehydrated if they do not want to eat or drink because of the pain. In addition, children with herpangina may vomit and may have a stomachache.

Another common cause of viral sore throat is mononucleosis. Mononucleosis occurs when the Epstein-Barr virus infects one specific type of lymphocytes. The infection spreads to the lymphatic system, respiratory system, liver, spleen and throat. Symptoms appear 30-50 days after exposure. Mononucleosis, sometimes referred to as a kiss disease, is extremely common. Often, the symptoms are mild, especially in young children, and are diagnosed as cold. Since the symptoms are more pronounced in adolescents and adults, in this age group more cases are diagnosed as mononucleosis. One of the main symptoms of mononucleosis is severe sore throat.

In about 30 percent of cases when children go to the doctor, the bacteria are found to be responsible for sore throat. Many of these bacterial sore throats are cases of strep throat. Sore throat caused by bacteria can be successfully treated with antibiotics. The most common bacterial sore throat is the result of infection with group A streptococcus. This type of infection is commonly called strep throat. Strep throat is a throat infection caused by a type of bacteria known as group A streptococcus. There are many types of streptococcal bacteria, but in particular this type causes streptococcal sore throat in children. This is the most common bacterial infection of the throat and is most common in children between the ages of five and fifteen.

Children become infected with streptococci through contact from person to person, usually through saliva or nasal secretions. Microbes can easily spread in areas where there is close contact, for example, in households. Even when exposed to tiny droplets of moisture that are released from the respiratory tract when sneezing or coughing, streptococcus in children can easily spread. Another common way to spread streptococcus is to shake hands with an infected person.

Speaking about the infectious causes of red throat in children, it should be noted a group of infections that have specific manifestations - it is scarlet fever measles. In addition to red throat and fever, they have a number of other manifestations that are characteristic of various pathogens.,

Other causes of sore throat may be of a non-infectious nature.

Allergies to pet dander, mold, dust and pollen can cause sore throat. The problem can be complicated by allergic rhinitis, which can irritate the throat, cause dryness and burning sensations or pain.

Dry indoor air, especially when heating buildings, can cause a child to feel pain and a burning sensation in the throat, especially in the morning when he wakes up. Breathing through the mouth — often due to chronic nasal congestion — can also cause a dry, sore throat.

External air pollution can cause permanent throat irritation. Internal pollution — tobacco smoke or chemicals — can also cause chronic inflammation of the throat.

Gastroesophageal reflux disease is a disorder of the digestive system, in which gastric acids or other stomach contents are maintained in the alimentary tube (esophagus). Other signs or symptoms may include heartburn, hoarseness, regurgitation of stomach contents, and a feeling of coma in the throat.

Although any child may have a sore throat, some risk factors make children more susceptible.

Seasonal allergies or continuing allergic reactions to pet dust, mold or dander make the development of a sore throat more likely. In such babies, in the presence of concomitant bronchial asthma, the risk of developing an infectious lesion of the throat is higher, because they may have complicated nose breathing.

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Risk factors

Chronic or frequent infections of the sinuses can be a risk factor. Drainage from the nose can irritate the throat or spread the infection, which becomes a permanent source of infection.

Weakened immunity is a risk factor for developing an infection of the throat. Common causes of reduced immunity include diabetes in a child, steroid treatment or chemotherapy drugs, stress, fatigue, and poor nutrition.

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Pathogenesis

The pathogenesis of the development of the red throat, whether it is a viral agent or a bacterial agent, is that the pathogen enters the mucous throat. There he begins to multiply rapidly, which leads to the destruction of epithelial cells of the nasopharynx. The immune system reacts to this, which leads to the activation of leukocytes, and they move into the area of penetration of viruses. They fight infection, which leads to hyperemia of the throat, fever, and pain in the throat.

[6], [7]

Symptoms

A sore throat is when your child complains of a throat. Your child’s throat can be dry, itchy, prickly, or painful. Pharyngitis and tonsillitis are infections in the throat that cause him pain. If the tonsils are primarily involved, it is called tonsillitis, and if the throat is primarily involved, then it is called pharyngitis.

The tonsils are small pieces of tissue in the back of the mouth, on either side of the tongue. The tonsils are part of the body's defensive lymphatic system. They help fight the germs that cause the infection and prevent the child from getting sick. Therefore, if the child complains of a sore throat, the mother should find other symptoms that may probably indicate these or other problems.

What mom can see is a red throat. In this case, you need to pay attention, it's just a red throat, or there is an increase in the tonsils, or there is a rash on the background of a red throat.

The first signs that the sore throat is infectious or bacterial in nature is that the body temperature rises. The level of increase in body temperature may be different. But if the child has a red throat during the inspection and high temperature, then you need to think about a viral or bacterial cause. If your child has a red throat, and also has other symptoms - cough, snot and temperature 37-39, then he is more likely to have a viral infection. With such an infection, the virus enters the mucous membranes of the upper respiratory tract, and causes rhinorrhea, inflammation of the throat, and as a result coughing appears. But symptoms can vary, depending on age. Younger children may not complain of sore throat, but they may refuse to eat or drink, take smaller amounts than usual, or cry when feeding and swallowing. Some children may have other symptoms, including cough, runny nose, and hoarse voice.

High fever, red throat and rash in a child may indicate a specific bacterial infection (scarlet fever, measles).

Scarlet fever usually begins with an infection caused by Streptococcus in the throat. Symptoms and signs of this infection include sore throat, headache, enlarged tonsils, fever, and chills. Nausea, vomiting, and abdominal pain may accompany these symptoms. The tongue may be swollen and have a red appearance, sometimes called a strawberry tongue. A rash is also characteristic of scarlet fever. It usually begins as small, flat red areas on the skin and can develop into large, uneven red areas. Usually the rash starts on the chest and head and spreads to the arms and legs, but the palms and the soles of the feet usually persist without a rash. Folds on the skin (groin, elbows, armpits) may appear more reddened. The skin may begin to peel off as the rash begins. Some babies will have a whitish coating on the tongue or throat and may have swollen glands of the lymph nodes.

Measles is an infectious viral disease that can be very unpleasant and sometimes leads to serious complications. Any child can get measles if it has not been vaccinated. The initial symptoms of measles develop approximately 10 days after infection. These may include: primary symptoms, such as runny nose, sneezing and coughing. Later there are sore, red eyes that may be sensitive to light, a sore throat and high fever, which can reach about 40 ° C. These first manifestations can be classified as ordinary pharyngitis. But later, small gray-white spots appear on the inside of the cheeks. After a few days, a red-brown spotted rash will appear. This usually begins on the head or upper neck, and then spreads to the rest of the body. A measles rash appears about 2-4 days after the initial symptoms and usually disappears after about a week.

But what is more common in children with red throats and high fever is streptococcal tonsillitis. Fever is very common for strep throat. A fever of more than 38.5 for more than three days is likely to be strep throat. And the higher the level of fever and the worse the child feels, the more likely it is that he has bacterial tonsillitis. For streptococcal infection is characterized by a very red throat with bright red spots on the back of the sky and white pus on the tonsils. Pain during swallowing and a significant increase in the cervical lymph nodes is also characteristic of streptococcal pharyngitis. No other symptoms, such as a runny nose, cough and mucus accumulation, other than sore throat and fever, streptococcal throat, as a rule, does not cause. However, if a child has diarrhea, fever and red throat, then such symptoms may occur with streptococcal infection. There is a characteristic rash that sometimes accompanies strep throat. It looks like red pimples all over the body and then it is already scarlet fever.

Diagnostics of the red throat with fever

Diagnosing a red throat in a child is not as difficult as it seems. An experienced mother herself can examine the child’s throat and determine the degree of throat redness and the presence of pus. But if mom is not sure, you need to see a doctor.

Diagnosis of a sore throat by a doctor begins with a physical examination of the throat and head. The doctor will also look for signs of other diseases, such as sinus infection or bronchitis. Since both bacterial and viral sore throats are infectious and are easily transmitted from person to person, the doctor will look for information about whether the patient was around other people with the flu, sore throat, cold or throat. When collecting complaints, you need to find out whether there was an increase in body temperature, and to what level, how long the child’s well-being lasts. Next you need to inspect the throat with a spatula.

With this examination, the tonsils can be seen in the back of the throat and with tonsillitis, they will be clearly red and inflamed. There is a tendency for viruses and bacteria to cause various types of inflammation. For example, the Epstein-Barr virus often causes red spots on the soft palate. Bacteria can leave a thin white membrane on the tonsils themselves. This can also be seen when examining and suspecting the diagnosis.

However, none of these symptoms is reliable enough to diagnose the cause of tonsillitis only from the appearance, so additional tests are often required. Traditionally, a throat swab is used for research, and then the smear is cultivated to see which bacteria are present, but there are also quick tests that can give results in minutes or hours.

The search for group A streptococcus on the tonsils does not prove that it causes inflammation, since many children carry the bacteria without any side effects.

But in the presence of fever and sore throat, a complete blood count is considered mandatory. It makes it possible, in accordance with the changes, to speak of a viral or bacterial etiology of inflammation of the throat.

If mononucleosis is suspected, the doctor may conduct a laboratory blood test to look for antibodies that indicate the presence of Epstein-Barr virus. Also carried out instrumental diagnostics - ultrasound examination of the abdominal cavity with visualization of the liver and spleen. With mononucleosis, there is a slight increase in these organs.

Differential diagnosis

Differential diagnosis of pharyngitis should be carried out primarily to verify the etiological factor. After all, for the treatment is very important, which caused redness of the throat. Infectious mononucleosis occurs most often in the older age group (adolescents) and, unlike acute tonsillitis, is not allowed after 1 week. It is accompanied by generalized lymphadenopathy, splenomegaly and hepatomegaly, as well as with constant fatigue, which is not observed with simple pharyngitis.

Simple pharyngitis needs to be differentiated with epiglottitis. A child with epiglottitis will have a muffled voice, and will drool; stridor and shortness of breath may occur. If epiglottitis is suspected, it is important not to waste time on performing blood tests or even trying to examine a child's throat: urgent consultation with a pediatric anesthesiologist is necessary to ensure the safety of the respiratory tract.

Peritonsular abscess causes more serious symptoms, including a muffled voice, a tongue dislocation and an increase in predominantly one tonsil. 

If a sore throat is associated with a viral infection, the symptoms are usually milder and often associated with a cold. If, due to infection with Coxsackie, small blisters develop on the tonsils, then after a few days blisters erupt, after which a scab appears, which can be very painful.

[8], [9], [10], [11], [12], [13], [14]

Treatment of the red throat with fever

Upper respiratory tract infections are quite infectious, and therefore those with such infections should avoid social contact. For children, the main focus of treatment is the pathogenetic approach, which the mother can implement even before consulting a doctor. The first thing that a mother can do is reduce the temperature with special children's means. Children use antipyretic analgesics, such as paracetamol and ibuprofen.

You can also reduce sore throat with some home care products. For times of sore throat, do not force your child to eat hard, hard foods. Offer him what the child wants to eat. Offer a warm tea to your child that will slightly reduce sore throat. Moisten the air, as this can reduce throat irritation and make breathing easier for children. Change the room humidifier water daily and clean the unit as directed to prevent the growth of harmful bacteria.

If the throat hurts because of a viral infection, then the main treatment is symptomatic remedies. To the treatment, you can add a means for washing the nose in the form of saline solutions, as well as sprays for the throat. You can use any spray that you have. They have a similar operating principle - they all have antiseptic properties and some anti-inflammatory. The only condition - you need to adhere to the age dosage.

Sore throat caused by streptococci or other bacteria should be treated with antibiotics. Penicillin is the preferred medicine, although other antibiotics are also effective if your child is allergic to penicillin. Oral penicillin should be taken within 10 days. Patients need to take all the necessary amount of antibiotics, even after symptoms of a sore throat improve. Discontinuing the antibiotic early can lead to a sore throat return.

1. Amoxicillin is the most commonly used antibiotic to treat streptococcal pharyngitis or tonsillitis. The method of use of the drug - in the form of a suspension three times a day. Dosage - 50 milligrams per kilogram of body weight. It is important that the child takes the antibiotic for a full 10 days, otherwise streptococcus may return. The most common side effects are allergic reactions, itchy skin, and digestive disorders.
2. Augmentin is a combination antibiotic containing amoxicillin and clavulanic acid, and can effectively treat bacterial infections that cause more severe sore throat. The method of use of the drug can be in the form of a suspension for young children, and for older children in the form of tablets. The dosage is calculated on amoxicillin and is also 50 milligrams per kilogram. Precautionary measures - in case of bronchial asthma in a child this group of drugs cannot be used.
3. Azithromycin is an antibiotic that is included in the group of macrolide drugs. Azithromycin is an effective drug against many bacteria that infect the respiratory tract and cause throat inflammation. The dosage of the drug is 10 milligrams per kilogram. The course of treatment with this antibiotic may be limited to five days, even with streptococcal infections, given the pharmacokinetic features of the drug. Method of application - in the form of tablets or suspensions. Side effects can be in the form of allergic reactions, dyspeptic disorders, as well as headaches.  
4. Oracept is a throat spray that is an antiseptic and anti-inflammatory agent that can be used in symptomatic treatment of sore throat. The drug is allowed to children from two years. Method of application - with a wide open mouth, you need to do two irrigations of the posterior pharyngeal wall, you need to repeat this at least three times a day. The side effects that can be frequent are an allergic reaction to the dye in the spray formulation. In the presence of allergies, repeated use of the drug is not recommended.

Vitamins can be used after the child recovers, as allergic reactions can occur during the illness.

What to do if the child often has a sore throat and this is accompanied by hyperthermia. Most likely, the child may have chronic tonsillitis. This is a condition in which the tonsils are constantly inflamed and are a chronic focus of infection. In addition, they are increased in size, which can worsen the nasal breathing of the child, cause snoring and disrupt the natural flow of air and its warming. In such cases, sometimes resorting to the use of surgical methods of treatment of pathology. Tonsillectomy is the removal of enlarged tonsils, which leads to the normalization of the condition. This procedure is not carried out by everyone, there are indications for its implementation. Currently, tonsillectomy is performed only when the tonsils are a chronic problem. As a rule, tonsillectomy is recommended for children who have: recurrent tonsillitis or streptococcal infections, shortness of breath due to swollen tonsils and adenoids, problem with swallowing. If your child has an ear or sinus infection without chronic tonsillitis, the doctor may recommend removing the adenoids (but not the tonsils).

The operation of tonsillectomy is usually done on an outpatient basis, so the child will need to stay only two to four hours after the operation, and not at night. There are some exceptions, for example, if a child drank poorly after surgery or has chronic health problems that require monitoring.

A child with a tonsillectomy is not allowed to eat or drink anything (even water) for about 12 hours before surgery.

The surgeon removes the tonsils - and, if necessary, adenoids - through your child's mouth, without making any cuts on the skin. The procedure takes from 30 to 45 minutes.

Your child will probably be given intravenous fluids during and after surgery. Then he will be taken to the recovery room, where the nurses will monitor him until he wakes up.

In certain cases, a second type of surgery is performed, called intracapsular tonsillectomy. In this procedure, a small amount of the amygdala remains to protect the muscles of the throat, resulting in less pain and less risk of bleeding during recovery. The disadvantage of intracapsular tonsillectomy is that in some cases the tonsils grow enough to cause problems again in the future. Intracapsular tonsillectomy is usually not performed in children with recurrent tonsillitis.

After a few days, your child may feel better, but a full recovery may take a week or even two. The child will be more susceptible to infection for some time, so at this time make special efforts to protect him from other ill.

Alternative treatment for red throat

Alternative treatments focus on alleviating the symptoms of a sore throat with the use of herbs and botanical medicines.

1. Mix 1/4 tablespoon salt with one cup of warm water. If you can explain to the child how to gargle, then he can do it with this solution.
2. Ginger and honey are great anti-inflammatory home remedies. To prepare the medication, peel a small piece of fresh ginger root and put it through a vegetable juicer and squeeze the juice. Mix fresh ginger juice with 3 tablespoons of lemon or lime juice (lemon and lime add vitamin C and antimicrobial properties) and add 3 tablespoons of honey. It is necessary to give the child such medicine three times a day in half a teaspoon. This will reduce throat irritation and pain sensation.
3. A warm infusion of ginger with added honey can also soothe a sore throat. Bring 6 cups of water to a boil and add four slices of fresh ginger root. Reduce heat and simmer for ten minutes. Let the mixture cool until it is slightly warmer than body temperature and mix with 2 - 3 tablespoons of honey. Let the child drink this tea several times a day.
4. Using Echinacea can boost the immune system and help speed up the recovery of a child with pharyngitis or tonsillitis. Echinacea can be helpful in combating the symptoms of bacterial infections of the upper respiratory tract. The recommended dose is 300 mg, three times a day. Echinacea is available in liquid extract, which can be added to a warm drink or tea to avoid ingestion of a pill or capsule.

Some homeopathic remedies can reduce the symptoms of redness in the throat, as well as speed recovery.

Hepar sulphuricum is indicated for stinging sore throat, which is accompanied by high hyperthermia. Pain can spread to the ears. The patient can be cold and feel extremely sensitive. The drug is dosed in granules - two granules per reception, three times a day in the acute period.

Mercurius solubilis is sometimes used to treat tonsils and sore throat with fever. The patient may perspire heavily and have excessive salivation. There may be indentations along the side of the tongue from the teeth and bad breath. Mercury is also indicated in cases where there is pus on the glands. It is used in granules of four granules four times a day.

Barrita carboxilla is another cure for tonsillitis. This remedy can be useful when the tonsils are very swollen and almost touch each other against the background of hyperemia of the pharynx. There may be pus on the tonsils, and the right tonsil may be more painful than the left. The drug is taken in the form of tablets - one tablet once a day.

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Complications and consequences

The consequences and complications that can arise if streptococcal throat in children is not treated can be as follows. Rarely, an infection of the throat spreads to the surrounding tissues of the neck and causes a large infectious tumor in the neck, called the peritonsillar abscess. A large mass will be visible on the side of the neck, and the child may have trouble swallowing or even breathing. This requires an immediate assessment in the doctor’s office or emergency room and intravenous antibiotic therapy.

Very rarely, streptococci enter the bloodstream and enter the heart, where they stick to one of the valves of the heart. Bacteria can form a small mass of infection on the valve, which prevents the heart from working. Symptoms include chest pain and shortness of breath, as well as persistent fever. Treating strep throat with an antibiotic virtually eliminates the risk of rheumatic fever.

Glomerulonephritis can be one of the consequences of poorly treated streptococcal tonsillitis. This concept means inflammation of the kidneys. It is not an actual kidney strep infection. This happens when the immune system creates antibodies to attack streptococcus, but the antibodies also inadvertently attack the kidneys, causing them to temporarily stop working. Blood in the urine is a sign of this complication and hospitalization should be mandatory.

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Prevention

Prevention of red throat in a child and high temperature is the prevention of various diseases in the first place. For this, it is necessary for the child to be in the open air more, to be actively involved in sports, the food was healthy. It is impossible to prevent sore throat, but the risk of passing the infection to another child can be minimized by hygiene measures:

1. washing hands well and often;
2. avoid close contact with a child who has a sore throat;
3. Do not share food and dishes with the sick.

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Forecast

The prognosis for recovery is favorable, even with streptococcal etiology of the disease. Children with bacterial sore throat begin to feel better about 24 hours after the start of antibiotics. The use of antibiotics during the first week of streptococcal infection will prevent complications. A sore throat caused by a viral infection usually resolves on its own within one week without complications.

Red throat and high fever are signs of infection of the upper respiratory tract in a child. But this is not a cause for great concern, because if these are symptoms of a viral infection, then the child can be treated at home. Only streptococcal lesion of the pharynx or tonsils requires the appointment of antibacterial agents, so you should consult a doctor.

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