Tami Griffith: February is Children’s Ear, Nose and Throat Month
Granby, CO Colorado
The number one reason that children visit their health care provider is due to ear, nose, and throat complaints. Ear infections are a common complaint in this category and sore throats are a close second.
Pharyngitis can be caused by a viral or bacterial infection. Viral infections are the most common cause of throat infections in children. Among the most common include:
Rhinovirus, Respiratory Syncytial virus, Adenovirus, and the Influenza virus. These infections typically cause the child to exhibit conjunctivitis, rhino rhea, cough, diarrhea, and often a viral rash.
The Coxsackie A virus causes “Hand, Foot, and Mouth” disease. The symptoms for this include: sore throat with vesicular lesions noted in the posterior portion of the throat as well as similar lesions seen on the hands and feet.
The Epstein-Barr virus causes mononucleosis in mostly the adolescent age group. These individuals complain of severe sore throat, anorexia, fatigue, fever, and enlarged anterior and posterior cervical lymph nodes.
Bacterial causes of pharyngitis include:
Acanobacterium Haemolyticum: This is an illness that usually affects teenagers. They will complain of a sore throat, fever, and a rash can be noted on the their hands and arms.
Mycoplasma pneumonia causes 5-16 percent of pharyngitis in children over the age of six.
Neisseria gonorrhaeae is rare but can be identified in sexually active teens.
The most common type of bacterial pharyngitis is GAS (Group A Streptococci). This type of bacterial infection is seen in approximately 15-30 percent of children ages 5-15 with pharyngeal complaints.
The normal presentation for this illness includes:
• White exudate noted on tonsils or posterior portion of throat
• Fever 101-103 degrees
• Anterior cervical lymphadenopathy (with the lymph nodes being greater than 1 cm in size)
• Abdominal pain
• Sand-paper type rash may also be noted.
This is usually seen in late fall, winter, or early spring.
Children younger than 3 often have atypical symptoms such as nasal congestion, rhinnorrhea, and low grade fever.
It is rare for the infant younger than 1 to have “Strep Throat”; however, they may develop this due to exposure from day care or older siblings with the illness. The infant is usually fussy, may run a low grade fever, and has a decreased appetite.
The incubation period for “Strep Throat” is two to four days and the signs and symptoms usually resolve in approximately 4-5 days, with or without treatment.
The concern with the untreated patient with GAS is the occurrence of Acute Rheumatic Fever. Rheumatic Fever is an inflammatory condition that can develop in a person with GAS. This disease can affect the heart, joints, skin ,and brain. Therefore, it is important to have your child be evaluated by a health care provider if they exhibit signs and symptoms of “strep throat”.
Studies have shown that individuals with GAS that were untreated, 50 percent still eliminated GAS from their upper respiratory tract 1 month after the initial infection.
Non-Group A Strep A and C are two other types of Strep bacteria that can cause pharyngitis. This infection is usually treated with antibiotics as is the GAS infection.
Your child may have a “Rapid Strep” test. This will be done by swabbing the posterior portion of the throat. The results will usually be ready in approximately 5 minutes. If the results are negative, then a throat swab may be sent off for “culture’. The lab will see if strep bacteria grows over a certain length of time. The results will usually be back to your provider’s office within 5-7 days.
The first line antibiotic for Strep infections is Penicillin. Children are often treated with Amoxil since they are more prone to taking a “bubble-gum” flavored medicine. The usual treatment is for 10 days.
Individuals with Non-Group A Strep A and C are usually treated for 5 days with antibiotics.
Symptomatic relief for viral and bacterial infections include:
Tylenol or Motrin every 4-6 hours as needed for fever and pain.
Salt Water Gargles: Mix 1 tsp of salt in 8 oz warm water and have the child gargle several times a day.
Plenty of liquids, including frozen items such as water popsicles, icees, and ice chips. This will help with fever, hydration, and with throat pain.
If your child has a bacterial infection, he will be contagious until he has been on antibiotics for approximately 24 hours.
While your child is still taking antibiotics, throw away his old toothbrush and provide him with a new one. Strep bacteria can be found on objects such as a toothbrush and utensils. It is important not to share food, drinks, or utensils with other family members until the child has been on antibiotics for approximately 24 hours.
Proper hand washing keeps bacteria from spreading as well.
For more information, contact Granby Medical Center: 887-7400
– Tami Griffith, CFNP-BC, works at Granby Medical Center and writes this column as a public service.
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