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

A sore throat and high temperature in a child is a common pathology that parents encounter, no matter what age the child is. But such a pathology does not always need to be treated with antibiotics. It is necessary to understand when parents can treat a sore throat themselves, and when it is definitely necessary to see a doctor.

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Causes red throat with fever in a baby

About 10 percent of children who visit a doctor each year have pharyngitis. Forty percent of cases when children go to the doctor with a sore throat, the sore throat is diagnosed as viral. Therefore, when talking about causes, it is necessary to understand when to think about viral etiology and when about bacterial.

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

By far the most common cause of sore throat in children is any one of a large number of viruses. These viruses can cause high fever and a very sore throat. Colds and flu are the main causes. These viruses cause inflammation in the throat and sometimes inflammation of the tonsils (tonsillitis). The flu virus can cause a sore throat in addition to its many other symptoms. The cough from the flu can also irritate the throat and so the pain can occur.

Coxsackievirus (hand, foot, and mouth disease) is a virus that causes high fever and painful sores on the throat, cheeks, 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 and is more common in the summer or early fall.

Another group of viruses that cause sore throats are adenoviruses. They can also cause lung and ear infections. In addition to a sore throat, symptoms that accompany an adenovirus infection include cough, runny nose, white bumps on the tonsils and throat, mild diarrhea, vomiting, and a rash. The sore throat lasts about a week.

Three to six days after exposure to the coxsackie virus, an infected child develops a sudden sore throat, accompanied by a significant fever, usually between 102-104°F (38.9-40°C). Tiny grayish-white blisters form in the throat and mouth. These fester and become small ulcers. The sore throat is often severe, making it difficult to swallow. Children may become dehydrated if they are unwilling to eat or drink because of the pain. Children with herpangina may also vomit and have abdominal pain.

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

In about 30 percent of cases when children go to the doctor, bacteria are found to be responsible for the sore throat. Many of these bacterial sore throats are cases of strep throat. Sore throats caused by bacteria can be successfully treated with antibiotics. The most common bacterial sore throat is the result of an 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 strep bacteria, but this type in particular causes strep throat in children. It is the most common bacterial throat infection and most often occurs in children between the ages of five and fifteen.

Children become infected with strep through person-to-person contact, usually through saliva or nasal secretions. The germs can spread easily in areas where there is close contact, such as households. Even exposure to tiny droplets of moisture released from the respiratory tract when someone sneezes or coughs can easily spread strep in children. Another common way to spread strep is by shaking hands with an infected person.

Speaking about infectious causes of sore throat in children, it is necessary to note a group of infections that have specific manifestations - these are measles, scarlet fever. In addition to sore throat and fever, they have a number of other manifestations that are characteristic of certain pathogens.

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

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

Dry indoor air, especially when buildings are heated, can cause your child to feel a sore, burning sensation in the throat, especially when they wake up in the morning. Mouth breathing – often due to chronic nasal congestion – can also cause a dry, sore throat.

Outdoor air pollution can cause chronic throat irritation. Indoor pollution, such as tobacco smoke or chemicals, can also cause chronic throat inflammation.

Gastroesophageal reflux disease is a digestive disorder in which stomach acids or other stomach contents are backed up into the food pipe (esophagus). Other signs or symptoms may include heartburn, hoarseness, regurgitation of stomach contents, and a feeling of a lump in the throat.

Although any child can get a sore throat, certain risk factors make children more susceptible.

Seasonal allergies or ongoing allergic reactions to dust, mold, or pet dander make it more likely for a sore throat to develop. Children with asthma are at higher risk for developing a throat infection because they may have difficulty breathing through their nose.

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Risk factors

Chronic or frequent sinus infections may be a risk factor. Drainage from the nose can irritate the throat or spread the infection, creating a constant source of infection.

A weakened immune system is a risk factor for developing a throat infection. Common causes of weakened immunity include diabetes in children, steroid or chemotherapy treatments, stress, fatigue, and poor nutrition.

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Pathogenesis

The pathogenesis of the development of a sore throat, whether it is a viral or bacterial agent, is that the pathogen gets on the mucous membranes of the throat. There it begins to multiply intensively, which leads to the destruction of the epithelial cells of the nasopharynx. The immune system reacts to this, which leads to the activation of leukocytes, and they move to the area of virus penetration. They fight the infection, which leads to hyperemia of the throat, fever, and the appearance of a sore throat.

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Symptoms

A sore throat is when your child complains about their throat. Your child's throat may be dry, itchy, scratchy, or painful. Pharyngitis and tonsillitis are infections in the throat that make it sore. If the tonsils are primarily involved, it is called tonsillitis, and if the throat is primarily involved, it is called pharyngitis.

The tonsils are small pieces of tissue at the back of the mouth, on either side of the tongue. The tonsils are part of the body's protective lymphatic system. They help fight germs that cause infection and prevent the child from getting sick. So if the child complains of a sore throat, the mother should look for other symptoms that may likely indicate one or another problem.

What mom can see is a red throat. It is important to pay attention to whether it is just a red throat, or whether there is an enlargement of the tonsils, or whether there is a rash on the background of a red throat.

The first sign that a sore throat is infectious or bacterial in nature is that the body temperature rises. The level of body temperature rise can vary. But if a child has a red throat upon examination and a 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, runny nose and a temperature of 37-39, then he most likely has a viral infection. With such an infection, the virus gets on the mucous membranes of the upper respiratory tract, and causes rhinorrhea, inflammation of the throat and, as a result, a cough. But symptoms can vary depending on age. Young children may not complain of a 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 hoarseness.

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

Scarlet fever usually begins with an infection of the throat caused by Streptococcus. Symptoms and signs of this infection include sore throat, headache, swollen 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 may develop into large, bumpy red areas. The rash typically begins on the chest and head and spreads to the arms and legs, but the palms of the hands and soles of the feet are usually left without a rash. Skin folds (groin, elbows, armpits) may appear more red. The skin may begin to peel as the rash begins. Some children will have a whitish coating on the tongue or throat and may have swollen lymph node glands.

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

But what is more common in children with a red throat and a high fever is strep throat. Fever is very common with strep throat. A fever of over 100.5 for more than three days is likely to be strep throat. And the higher the fever and the worse the child feels, the more likely it is that he or she has bacterial tonsillitis. Strep throat is characterized by a very red throat with bright red spots on the back of the roof of the mouth and white pus on the tonsils. Pain when swallowing and significant swelling of the lymph nodes in the neck are also characteristic of strep pharyngitis. Strep throat usually does not cause any other symptoms such as a runny nose, cough, and mucus accumulation except for the sore throat and fever. However, if a child has diarrhea, fever, and a red throat, then such symptoms may occur with a strep infection. There is a characteristic rash that sometimes accompanies strep throat. It looks like red pimples all over the body and then we are talking about scarlet fever.

Diagnostics red throat with fever in a baby

Diagnosing a child's sore throat is not as difficult as it seems. An experienced mother can examine the child's throat herself and determine the degree of redness of the throat and the presence of pus. But if the mother is not sure, it is necessary to consult a doctor.

A doctor's diagnosis of a sore throat begins with a physical examination of the throat and head. The doctor will also look for signs of other illnesses, such as a sinus infection or bronchitis. Since both bacterial and viral sore throats are contagious and easily spread from person to person, the doctor will look for information about whether the patient has been around other people with the flu, sore throat, colds, or throat infections. When collecting complaints, it is necessary to find out whether the body temperature has increased, to what level, how long it has lasted, and how the child feels during this time. Next, the throat should be examined with a spatula.

On this examination, the tonsils can be seen at the back of the throat and will be visibly red and inflamed if tonsillitis is present. There is a tendency for viruses and bacteria to cause different 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 on examination and may suggest a diagnosis.

However, none of these symptoms are reliable enough to diagnose the cause of tonsillitis based on appearance alone, so additional testing is often required. Traditionally, a throat swab is used to test the infection, and then the swab is cultured to see what bacteria are present, but there are also rapid tests that can give results in minutes or hours.

Finding group A strep on the tonsils does not prove that it is causing the inflammation, as many children carry the bacteria without any ill effects.

But if there is a fever and sore throat, a general blood test is considered a mandatory test. It makes it possible to talk about the viral or bacterial etiology of the inflammation of the throat in accordance with the changes.

If mononucleosis is suspected, the doctor may conduct a laboratory blood test to look for antibodies indicating the presence of the Epstein-Barr virus. Instrumental diagnostics are also performed - an ultrasound examination of the abdominal organs with visualization of the liver and spleen. With mononucleosis, a slight increase in these organs is observed.

Differential diagnosis

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

Simple pharyngitis must be differentiated from epiglottitis. A child with epiglottitis will have a muffled voice and will drool; stridor and difficulty breathing may occur. If epiglottitis is suspected, it is important not to waste time running blood tests or even attempting to examine the child's throat: urgent consultation with a pediatric anesthesiologist is necessary to ensure the airway is secure.

A peritonsillar abscess causes more severe symptoms, including a muffled voice, displacement of the uvula, and enlargement of predominantly one tonsil.

If the sore throat is due to a viral infection, the symptoms are usually milder and often associated with a cold. If a Coxsackie virus infection causes small blisters to develop on the tonsils, the blisters break out within a few days, followed by a scab that can be very painful.

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Treatment red throat with fever in a baby

Upper respiratory tract infections are quite contagious, and therefore those who have such infections should avoid social contact. For children, the main direction of treatment is the pathogenetic approach, which the mother can implement even before consulting a doctor. The first thing the mother can do is to reduce the temperature with special children's products. In children, antipyretic analgesics are used, such as paracetamol and ibuprofen.

You can also relieve a sore throat with some home remedies. When a sore throat occurs, do not force your child to eat hard, tough foods. Offer them something they want to eat. Offer warm tea, which may help soothe a sore throat. Humidify the air, which can reduce throat irritation and make it easier for children to breathe. Change the water in room humidifiers daily and clean the device as directed to prevent the growth of harmful bacteria.

If your throat hurts due to a viral infection, the main treatment is symptomatic remedies. You can add nasal rinsing agents in the form of saline solutions and throat sprays to the treatment. You can use any spray you have. They work in a similar way - they all have antiseptic properties and some anti-inflammatory ones. The only condition is to adhere to the age-appropriate dosage.

Sore throats caused by streptococci or other bacteria should be treated with antibiotics. Penicillin is the preferred drug, although other antibiotics are also effective if the child is allergic to penicillin. Oral penicillin should be taken for 10 days. Patients should take the entire amount of antibiotics needed, even after sore throat symptoms improve. Stopping the antibiotic early may cause the sore throat to return.

1. Amoxicillin is the most commonly used antibiotic for the treatment of streptococcal pharyngitis or tonsillitis. The drug is administered as a suspension three times a day. The dosage is 50 milligrams per kilogram of body weight. It is important that the child takes the antibiotic for 10 days, otherwise the streptococcus may return. The most common side effects are allergic reactions, itchy skin, and digestive problems.
2. Augmentin is a combination antibiotic containing amoxicillin and clavulanic acid and can effectively treat bacterial infections that cause more severe sore throats. The drug can be administered as a suspension for small children and as tablets for older children. The dosage is calculated based on amoxicillin and is also 50 milligrams per kilogram. Precautions - this group of drugs cannot be used in children with bronchial asthma.
3. Azithromycin is an antibiotic that belongs to the group of macrolide drugs. Azithromycin is an effective drug against many bacteria that infect the respiratory tract and cause sore throat. The dosage of the drug is 10 milligrams per kilogram. The course of treatment with this antibiotic can be limited to five days, even with streptococcal infection, given the pharmacokinetic properties of the drug. Method of administration - in the form of tablets or suspension. Side effects can be in the form of allergic reactions, dyspeptic disorders, and headaches.
4. Orasept is a throat spray that is an antiseptic and anti-inflammatory agent that can be used in the symptomatic treatment of sore throat. The drug is approved for children from two years of age. Directions for use: with the mouth wide open, spray the back of the throat twice, repeating this at least three times a day. Side effects that can be common are allergic reactions to the dye in the spray. If you have an allergy, re-use of the drug is not recommended.

Vitamins can be used after the child has recovered, as allergic reactions may occur during illness.

What to do if a child has frequent sore throats 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 source of infection. In addition, they are enlarged in size, which can worsen the child's nasal breathing, cause snoring and disrupt the natural flow of air and its warming. In such cases, surgical methods of treating the pathology are sometimes used. Tonsillectomy is the removal of enlarged tonsils, which leads to normalization of the condition. This procedure is not performed on everyone, there are indications for it. 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, difficulty breathing due to swollen tonsils and adenoids, problems with swallowing. If your child has recurring ear or sinus infections without chronic tonsillitis, your doctor may recommend removing the adenoids (but not the tonsils).

Tonsillectomy surgery is usually performed on an outpatient basis, so your child will only need to stay in for two to four hours after surgery, not overnight. There are some exceptions, such as if your child has not been drinking well since surgery or has chronic health problems that require monitoring.

A child having 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, the adenoids - through your child's mouth, without making any cuts to the skin. The procedure takes about 30 to 45 minutes.

Your child will likely be given intravenous fluids during and after surgery. Then they'll be taken to a recovery room where nurses will monitor them until they wake up.

In certain cases, a second type of surgery called intracapsular tonsillectomy is performed. In this procedure, a small amount of tonsil is left to protect the throat muscles, 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 not usually performed on children with recurrent tonsillitis.

Your child may feel better in a few days, but it may take a week or two to fully recover. Your child will be more susceptible to infection for a while, so make special efforts to keep him or her away from other sick people during this time.

Folk remedies for sore throat

Folk remedies focus on relieving sore throat symptoms using herbs and botanicals.

1. Mix 1/4 tablespoon of salt with one glass of warm water. If you can explain to your child how to gargle, he can do it with this solution.
2. Ginger and honey are great anti-inflammatory home remedies. To make the medicine, peel a small piece of fresh ginger root and put it through a vegetable juicer to extract the juice. Mix the 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. Give your child half a teaspoon of this medicine three times a day. This will reduce the irritation in the throat and the feeling of pain.
3. A warm ginger infusion with honey added 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 to 3 tablespoons of honey. Give your child this tea several times a day.
4. Using Echinacea can boost the immune system and help speed up a child’s recovery from pharyngitis or tonsillitis. Echinacea can be helpful in combating the symptoms of bacterial upper respiratory infections. The recommended dose is 300 mg, three times daily. Echinacea is available in a liquid extract that can be added to a warm drink or tea to avoid swallowing a tablet or capsule.

Some homeopathic remedies can reduce the symptoms of a sore throat and also speed up recovery.

Hepar sulphuricum is indicated for stinging pains in the throat, which are accompanied by high fever. The pain may extend to the ears. The patient may be cold and feel extremely sensitive. The drug is dosed in granules - two granules per dose three times a day in the acute period.

Mercurius solubilis is sometimes used to treat tonsil and throat pains accompanied by fever. The patient may sweat profusely and have excessive salivation. There may be indentations along the side of the tongue from the teeth and a foul odor from the mouth. Mercury is also indicated when there is pus on the tonsils. It is given in granules, four granules four times a day.

Barrita carboxilla is another remedy 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 tablet form - one tablet once a day.

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Complications and consequences

The consequences and complications that can occur if strep throat in children is not treated may include the following. Rarely, the throat infection spreads to the surrounding tissues of the neck and causes a large infectious swelling in the neck area called a 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 immediate evaluation in the doctor's office or emergency room and intravenous antibiotic therapy.

Very rarely, strep bacteria enter the bloodstream and travel to the heart, where they stick to one of the heart valves. The bacteria can form a small mass of infection on the valve, which prevents the heart from working properly. Symptoms include chest pain and shortness of breath, as well as persistent fevers. 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 term means inflammation of the kidneys. It is not an actual streptococcal infection in the kidneys. It occurs when the immune system creates antibodies to attack the 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 a sore throat and high temperature in a child is prevention of various diseases first of all. To do this, the child needs to be outdoors more, actively play sports, and eat healthy. It is impossible to prevent sore throat, but the risk of transmitting the infection to another child can be minimized by hygienic measures:

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

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Forecast

The prognosis for recovery is good, even with strep throat. Children with bacterial sore throats begin to feel better about 24 hours after starting antibiotics. Using antibiotics during the first week of a strep throat infection will prevent complications. Sore throats caused by viral infections usually resolve on their own within a week without complications.

A sore throat and high temperature are signs of an upper respiratory tract infection in a child. But this is not a reason for great concern, because if these are symptoms of a viral infection, the child can be treated at home. Only streptococcal lesions of the pharynx or tonsils require the prescription of antibacterial agents, so you need to consult a doctor.

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