Should Children with Sore Throat and Fever be Taken to the Hospital?

Pharyngitis is a common illness among children that requires prompt detection and treatment to prevent complications such as respiratory tract infections, otitis media, purulent lymphadenitis, or acute glomerulonephritis. 

Therefore, parents should remain vigilant and exercise caution. It is advisable to take a child to the hospital promptly if they have a persistent sore throat and fever accompanied by severe warning signs of a serious condition.

1. Causes of Sore Throat in Children

Acute pharyngitis is characterized by the rapid inflammation of the pharynx, and there are various causes of sore throat in children, including:

Environmental factors: Sudden weather changes, damp and rainy weather, exposure to car smoke, secondhand smoke, and airborne dust are common triggers of nasopharyngitis in children. Additionally, children who have recently weaned, changed their diet, or started attending kindergarten may experience nasopharyngitis due to their limited adaptation to new environments.

Infectious agents: Viruses (such as influenza, measles, adenovirus), bacteria (such as pneumococcus, staphylococcus, streptococcus), and fungi (such as Candida) can also cause sore throats in children.

2. When to Take a Child to the Hospital for Sore Throat and Fever

Children with acute nasopharyngitis often exhibit symptoms such as mild to high fever (ranging from 39-40 degrees Celsius), runny or stuffy nose, cough, sneezing, sore throat, headache, and initially, a dry cough that progresses to a productive cough with sputum. Other signs may include irritability, loss of appetite, disrupted sleep, mouth breathing due to nasal congestion, vomiting, and loose stools.

Parents should promptly seek medical attention for their child if they have a sore throat and fever that persists for several days and display any of the following symptoms:

• Continuously high fever that does not respond to medication or warm compresses, which may lead to seizures.
• Excessive coughing, difficulty breathing, or shortness of breath, with accelerated breathing and chest tightness.
• Ear discharge.
• Frequent vomiting or multiple episodes of loose stools in a day.
• Lack of improvement after two days of treatment.

If left untreated, a sore throat and fever in children can last for 7-10 days and potentially lead to complications such as tonsillitis, otitis media, sinusitis, bronchitis, laryngitis, purulent lymphadenitis, arthritis (progressive rheumatic heart disease), acute glomerulonephritis (if caused by group A streptococcus bacteria - S. pyogenes), and, most dangerously, bacteremia.

3. Caring for a Child with Sore Throat and Fever

3.1. Nasopharyngeal Hygiene

• For mild nasal congestion with thin nasal discharge, parents can gently wipe the child's nose with a soft cloth. In cases of thicker nasal secretions or a runny nose, putting 2-3 drops of physiological saline in each nostril can help soften the mucus. Afterward, gently rub the child's nose to remove softened and flaky nasal discharge.
• If nasal discharge is excessive and thick, a nasal aspirator can be used to remove it. However, nasal suction should not be overused as it may damage the nasal mucosa. Adults should never use their mouth to directly suck the child's nose or drool.
• Use a soft tissue to wipe the child's nose and drool, disposing of it immediately after use. Avoid using a hand towel, as bacteria and viruses can linger on it and contribute to further illness.
• Follow the doctor's instructions for using vasoconstrictors if the child has a persistent sore throat and fever.

Note: When children have nasopharyngitis, parents can use physiological saline for nasal irrigation and gargling, but they should strictly follow the doctor's instructions.

3.2. Adjusting the Child's Diet

• Provide the child with nutritious, soft, easy-to-swallow, and digestible foods.
• Ensure the child drinks plenty of water, preferably oral rehydration solution or fruit juice.
• Offer food to the child in smaller, more frequent meals based on their appetite. Avoid forcing them to eat the entire portion, as decreased appetite is common when children are sick.
• Steamed kumquats with honey, ginger, lemon, or other suitable ingredients can be given to children to alleviate cough symptoms.

3.3. Administering Medication as Prescribed

Parents should avoid using antibiotics without proper medical guidance and refrain from reusing old prescriptions from previous visits. Similarly, vasoconstrictor medications for sore throat and fever should not be used for an extended period without a doctor's prescription.

When a child has a sore throat and fever that persists for several days, it is recommended to consult an ear, nose, and throat (ENT) specialist for a prompt diagnosis and appropriate treatment. This proactive approach will effectively address the illness and minimize the risk of unforeseen complications.