Your Child Has a Sore Throat: What's the Cause?

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A sore throat is one of the most common concerns among parents of school-aged children.

Here is information from the American Academy of Pediatrics about sore throats and their causes. Also included is information about strep throat tests, tonsillitis, how to prevent the spread of germs, and when to call the doctor.

Sore Throat Caused by Viruses

The most frequent cause of sore throat in children is a viral infection. Often it is the first sign of a common cold. Your child may develop a mild fever too.

Signs and Symptoms

  • Swollen, tender glands in the neck

  • Difficulty swallowing

  • Fever

  • Headache

  • Stuffy or runny nose and sneezing

  • Mild cough

  • Congestion


Viral infections cannot be treated with antibiotics. Antibiotics will not work because they target and fight against bacteria, not viruses.

The body needs to fight the virus on its own. Make sure your child gets plenty of rest and fluids. Viral sore throats usually go away in 3 to 5 days.

If your child has a fever, you can make him more comfortable by reducing his temperature with acetaminophen or ibuprofen. You can also give him cool drinks and soft foods that are easy to swallow. Making sure he has enough to drink is really important.

Sore Throat Caused by Bacteria

Strep throat is an infection caused by a specific type of bacteria, Streptococcus pyogenes. When your child has a strep throat, the tonsils are usually very inflamed. The inflammation may affect the surrounding part of the throat as well. Strep throat most commonly affects school-aged children, but it may occur in children as young as 3 years of age.

Signs and Symptoms

  • Pain in the throat, especially when swallowing

  • Red or white patches in the throat

  • Swollen, tender glands in the neck

  • Fever

  • Headache

  • Stomach pain

  • Vomiting

Strep throat has many of the same symptoms as a sore throat from a virus. However, treatment for a strep throat is different than treatment for a sore throat caused by a virus. Your child's doctor may do a test to determine what is causing the pain. Streptococcal (strep) infections are treated with antibiotics.


If an antibiotic is prescribed for your child's bacterial sore throat,

  • Make sure your child takes all the medicine exactly as directed, even if he feels better. If antibiotic treatment stops too soon, the infection may worsen or spread in the body. Call the doctor if your child is not getting better with treatment.

  • If the antibiotic is a liquid, ask your child's doctor for the right dosage in milliliters (mL) for your child's age and size. Always measure each dose using a device (syringe, cup, or spoon) that is marked in milliliters.

Strep Throat Tests

Most doctors' offices do rapid strep throat tests that provide findings within minutes. If the result of this test is negative, your doctor may confirm it with a throat culture. To do this, she will touch the back of the throat and tonsils with a cotton-tipped applicator. Then she will smear the tip onto a special small dish that allows strep bacteria to grow if they are present. The dish is examined 24 hours later to determine whether the bacteria are present.

A negative test result means that the infection is likely caused by a virus. In that case, antibiotics (that target and fight against bacteria, not viruses) will not help and do not need to be prescribed.

How to Prevent the Spread of Germs

Most types of throat infections are contagious. They are passed primarily through the air on droplets of moisture, or on the hands of infected children or adults. So handwashing is very important. Other ways to help keep germs from spreading...

About Tonsillitis

On each side of your child's throat is a pink, oval-shaped mass called a tonsil. Tonsillitis is a common illness and refers to swollen tonsils, usually from an infection. A sore throat is one of the symptoms. Other signs of tonsillitis include

  • White or yellow coating over the tonsils

  • A throaty voice

  • Uncomfortable or painful swallowing

  • Swollen, tender lymph nodes (glands) in the neck

  • Fever

If your child has a sore throat and other signs of tonsillitis, let your child's doctor know.

  • Cough and sneeze into a tissue. If you don't have time to get a tissue, bend your arm and sneeze into it.

  • Throw away tissues in a wastebasket or trash can right after each use.

  • Keep your child away from anyone who has a cold, fever, or runny nose.

  • Don't share spoons, forks, or drinking cups with anyone who has a cold, fever, or runny nose.

  • Wash dishes in hot, soapy water.

When to Call Your Child's Doctor

If a sore throat develops with the following symptoms, call your child's doctor.

  • A fever (temperature higher than 102F [38.9C])

  • Pus on the tonsils

  • Severe throat pain

  • Not taking fluids well

  • Ear pain

  • Swelling of the glands in the neck that gets worse

  • A hard time breathing

  • Severe headache

  • Red, tender joints several weeks after the sore throat

  • Dark urine up to 3 or 4 weeks after the sore throat

  • A rash

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances..