What is it about ?
Inflammation of the throat wall (pharyngitis) is often associated with inflammation of the tonsils (tonsillitis or tonsillitis).
The main symptoms are fever and sore throat. Symptoms in the nose, ear pain, coughing or rash are also possible.
Usually, these inflammations are caused by a virus (an adenovirus). In children, angina is usually caused by a virus. This is especially the case when other symptoms are added to the sore throat.
The mononucleosis can also cause sore throat.
In whom and how often do they occur?
These ailments are frequent. Angina mononucleosis represents 1 to 10% of cases of acute sore throat and mainly affects adolescents.
Angina of bacterial origin is rare in children under 3 years old.
How to recognize them?
The child suddenly complains of a sore throat and a general feeling of discomfort. He may be “woozy” (listless) and have less appetite.
With mononucleosis, there is a sore throat, fever, fatigue, and large painful nodes in the neck. Complaints last more than 7 days.
How is the diagnosis made?
The doctor will listen to complaints and do a clinical examination of the child. He will examine the nose, throat and ears and will feel the lymph nodes in the neck.
Additional examinations are rarely necessary. You should not differentiate between bacterial and viral infections. Throat cultures (taking a sample from the throat with a cotton swab) are therefore not very helpful.
What can you do ?
Usually, you recover on your own from these infections after a week, even if you have a strep infection (bacteria).
Here is what your child can do to relieve a sore throat:
- Drink regularly or suck lozenges;
- Get enough rest;
- Eat soft foods and avoid acidic drinks.
It is possible to avoid transmitting contagious germs through good hand hygiene.
What can your pharmacist do?
Paracetamol is the first choice for pain and general signs of illness (such as fever).
A nonsteroidal anti-inflammatory drug (eg ibuprofen) may be an alternative. These drugs have more side effects than paracetamol. They should be avoided in case of dehydration and gastrointestinal problems.
Aspirin is not recommended for viral infections because it can cause serious complications, fortunately rare.
We do not have sufficiently reliable evidence for lozenges, tablets that melt in the mouth (orodispersible), throat sprays or mouthwashes for sore throat. The same goes for echinacea products.
What can your doctor do?
If the angina is not serious, therefore without increased risk of complications, the doctor will explain that it is an annoying condition but absolutely harmless and that it will disappear spontaneously after 7 to 10 days.
In most cases, the doctor will not prescribe antibiotics, but pain relievers.
If the child is seriously ill and the sore throat and difficulty swallowing are very pronounced, antibiotics may be considered.
The doctor will prescribe antibiotics in certain situations, for example:
- The child is at risk of complications (for example because he is being treated with chemotherapy or because he has a problem with the valves of the heart);
- Outbreak of confirmed bacterial infection of the throat with streptococcus in a closed community (for example, a facility that accommodates people with intellectual disabilities). He must do so because of the risk of contamination for other children who cohabit and are therefore in close contact with the sick child.
The first choice antibiotic is penicillin prepared by the pharmacist. Another possibility is a cephalosporin, cefadroxil.
If the doctor suspects complications, such as an abscess with possible displacement of the uvula, the child will be sent to the hospital.
Consideration may be given to having the tonsils removed, especially if the child has had several tonsillitis and these tonsillitis have been noted by a doctor and have been well treated.
- At least 7 tonsillitis over the past year;
- At least 5 tonsillitis per year over the past 2 years;
- At least 3 tonsillitis per year over the past 3 years.
Ask the doctor for advice on this.
Want to know more?
- When should a child be given medicine? – FAMHP – Federal Agency for Medicines and Health Products
- Paracetamol – CBIP – Belgian Center for Pharmacotherapeutic Information
- Ibuprofen – CBIP – Belgian Center for Pharmacotherapeutic Information
- Antibiotics do not act against all diseases – BAPCOC – Belgian Commission for the coordination of antibiotic policy
- Cefadroxil – CBIP – Belgian Center for Pharmacotherapeutic Information
Sources
- Foreign clinical practice guide ‘Pharyngitis and tonsillitis in children’ (2000), updated on 01.12.2016 and adapted to the Belgian context on 15.10.2018 – ebpracticenet
- Zelfzorgadvies in de apotheek, Praktijkgids 2. S. Cornwell, V. Foulon. Publisher Acco. 2018 edition.
raktijkgids 2. S. Cornwell, V. Foulon. Publisher Acco. 2018 edition.