Always ensure that infection is effectively treated. FOTOSEARCH
One of the most common childhood complaints is a sore throat. It mainly affects young school-going children and is highly contagious.
Sore throats occur when germs invade the area at the back of the mouth. Most of the time it is caused by viruses but it can also be caused by bacteria or fungus. This results in throat pain and difficulty in feeding.
In addition to throat pain, most children also have swelling of the nodes at the front of the neck, headache, fever, vomiting, nausea and even abdominal pain.
In rare circumstances, sore throats can be caused by acid coming from the stomach and irritating the throat (reflux) or from getting into contact with other throat irritants like smoke.
The infective sore throat is the main focus of our article today and specifically we are trying to get to understand the ominous side of bacterial sore throats caused by a germ known as strep.
If a sore throat is not adequately addressed, it can spread up into the ear resulting in marked ear pain. If not treated in good time, the ear drum can perforate causing a pus-like fluid to come out of the ear.
Infection in the throat can move up to small cavities in the child’s facial bones known as sinuses. This leads to severe headaches affecting the front part of the head and production of a thick, greenish mucus from the nose.
Sometimes the child’s kidneys may stop being very efficient after a severe throat infection. They will produce reduced amounts of dark urine, swelling of the feet and sometimes around the eyes.
In some cases, the child can even develop high blood pressure. Fortunately, kidney problems that occur under such circumstances tend to resolve and most children recover well.
Heart disease
The most common cause of acquired heart disease in Kenyan children is known as rheumatic heart disease which is directly connected to bacterial sore throats.
In most cases, the child does not initially have symptoms but as they get older, they begin to have difficulty breathing during day-to-day activities and sometimes end up with heart failure.
Nerve problems
In rare cases, a child can develop nerve problems a few months after a sore throat. This is characterised by purposeless movements of the face and limbs.
Clinicians often mistakenly diagnose this as epilepsy – especially since most parents do not mention any problems the child had in the past with sore throats.
The child can develop pain and swelling of the joints. It usually begins with the legs and moves upwards. However, some children get a milder form where there is no joint swelling yet there is pain.
Sometimes the child can get a skin rash that affects the face, belly and upper limbs. In lighter skinned children, it has a characteristic reddish colour. Usually this rash heals within a week or so with scaling of the skin.
If the throat infection is not effectively treated, the area around the tonsils begins to develop pus which collects and forms a large pool known as an abscess in the neck. This collection of pus is extremely painful and usually needs to be drained through surgery.
Sometimes the infection can spread to the lungs leading to development of pneumonia which is characterised by a cough, rapid breathing and sometimes even wheezing.
Meningitis
The infection can spread to the lining of the brain and spinal cord leading to a stiff neck, confusion, severe headache and even coma. This is a life-threatening condition which warrants emergency care.
There is on-going research trying to see if sore throats may be related to the development of mental illnesses such obsessive compulsive disorder.
Usually most doctors can tell if the sore throat is bacterial from looking at the child’s throat. However, for definitive diagnosis, a throat swab should be done. This involves putting something that looks like a long cotton bud into the child’s throat to take a sample of the secretions there. This swab is then taken to the lab for analysis.
Antibiotics or not?
The greatest frustration most parents with school-going children have is the large amounts of antibiotics they take during the school year. To prevent this, it is important to only give your child antibiotics when it is absolutely necessary.
As a general rule, sore throats accompanied by sneezing, runny nose and coughs tend to be caused by a virus and not bacteria (strep). They, therefore, do not need antibiotics. They only need painkillers and gargles (either antiseptic ones or salty water).
If in doubt of the cause of the sore throat, visit your paediatrician. All bacterial sore throats must be treated with antibiotics.
Currently, there is no vaccine to prevent bacterial sore throats. However, those caused by flu viruses can be reduced by taking your child for an annual flu vaccine.
