The difference between a sore throat, pharyngitis and tonsillitis

 


The difference between a sore throat, pharyngitis and tonsillitis

The terms sore throat, pharyngitis and tonsillitis are often used interchangeably, but they are not the same thing.

    Tonsillitis refers to the tonsils that are inflamed.

    Pharyngitis is an infection caused by a specific type of bacteria, streptococcus. When your child has pharyngitis, the tonsils often become very inflamed, and inflammation can affect the surroundings of the throat.

    Other causes of sore throat are viruses, and these can only cause inflammation of the throat around the tonsils but not the tonsils themselves.

Sore throat

In infants, toddlers and preschoolers, the most common cause of sore throat is a viral infection. No specific medicine is needed when the responsible person is a virus, and the child should improve in a period of seven to ten days. Often children who have a sore throat caused by viruses also have a cold. They may also have a mild fever, but usually the disease is not very strong.

A specific virus (called Coxsackie virus), which is seen more often in the summer and fall, can cause a slightly higher fever, more difficult to swallow and more discomfort in general. If your child has a Coxsackie virus infection, you may also have one or more blisters on your throat and on your hands and feet (so it is usually called hand-foot-mouth disease). Infectious mononucleosis can cause sore throat, often with marked tonsillitis; however, most children who have a mononucleosis virus infection have few or no symptoms.
Pharyngitis

Pharyngitis is caused by a bacteria called Streptococcus pyogenes. To some extent, the symptoms of pharyngitis depend on the age of the child.

    Babies: may have only a low fever and a thick or bloody nasal discharge.
    Young children: may also have a thick or runny nose with blood and fever. These children are often irritable, lose their appetite and often have inflamed lymph nodes in their necks. Sometimes young children complain of stomachache and not sore throat.
    Children over three years: usually have stronger symptoms; the sore throat can be extremely painful, the fever rises above 102 degrees Fahrenheit (38.9 degrees Celsius), there are swollen nodes in the neck and pus in the tonsils.

It is important to be able to distinguish a pharyngitis (streptococcal infection) from a viral infection, because streptococcal infections are treated with antibiotics.
Diagnosis and treatment

If your child has a sore throat that does not go away (not one that goes away after drinking something in the morning), whether accompanied by fever, headache, stomach pain or extreme tiredness, you should call your pediatrician. That call should be made more urgently if your child seems to be extremely ill, or if he has difficulty breathing or has a hard time swallowing (which causes him to drool).
Throat culture

This may be an indication of a more serious infection. The doctor will examine your child and may have a throat culture to determine the nature of the infection. For this, he will touch the back of the throat and tonsils with a cotton-tipped applicator and rub the tip into a special culture dish that allows streptococcus bacteria to grow if present. The culture plate is examined twenty-four hours later to determine the presence of the bacteria.
Rapid examination of pharyngitis

Most pediatricians' offices do rapid strep tests that give results in minutes. If the rapid test is negative, your doctor may confirm the result with a culture. A negative test means that it is assumed that the infection is caused by a virus. In that case, antibiotics (which are antibacterial) do not help and will not be prescribed.
Antibiotics




If the test shows that your child does have pharyngitis, the pediatrician will prescribe an oral or injected antibiotic. If it is oral, it is very important that you take the full dose, as prescribed, even if the symptoms improve or disappear.

If your child's pharyngitis is not treated with antibiotics, or if the treatment is not completed, the infection may worsen or spread to other parts of the body, leading to conditions such as abscesses of the tonsils or kidney problems. Streptococcal infections that are left untreated can result in rheumatic fever, a disease that affects the heart. However, rheumatic fever is rare in the United States and in children under five years of age.
Prevention

Many types of throat infections are contagious, transmitted mainly by air in small drops of moisture or in the hands of infected children or adults. For that reason, it makes sense to keep your child away from people who have symptoms of this condition. However, most people are contagious before the first symptoms appear, so there is really no practical way to prevent your child from catching the disease.

In the past, when a child had several throat infections, it was likely that his tonsils were removed in an attempt to prevent further infections. But this operation, called tonsillotomy, is now only recommended for severely affected children. Even in difficult cases, where there are repeated infections, antibiotic treatment is usually the best solution.