Family Health Guide

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Sore Throat: Diagnosis

If your child has a persistent sore throat that does not get better after he has a drink or two in the morning, or has other symptoms that are making him uncomfortable, it’s time to see the doctor.

To figure out if a child needs treatment, your doctor will first examine her throat using a tongue depressor and lighted instrument. If he suspects strep throat, he'll perform a throat culture, which involves taking a sterile swab and rubbing it on the back of your child’s throat and tonsils to collect a sample of the strep bacteria (if any). Lab results for this test usually take 24 hours (and can take up to three days). Most pediatricians now also offer a  rapid antigen test, which is faster but less sensitive, and can give results in as few as ten minutes. However, doctors will still confirm these with traditional throat culture results, even if the rapid antigen test is negative, because this type of test doesn’t catch the strep bacteria 100% of the time. Rapid DNA tests are emerging as another fast and more thorough way to diagnose strep, but they’re far from being universally present in pediatric offices. If the symptoms are textbook, some pediatricians will prescribe a course of antibiotics before results of the strep test are in, but others won't because antibiotics won’t cure a virus, and using them unnecessarily can lead to a resistance build-up.

If epiglottitis is suspected, your doctor will first make sure your child is getting enough oxygen. Once the airway is secure, your doctor might then order a chest or neck x-ray as well as a blood test to check for sepsis, a serious infection of the blood stream that often goes hand-in-hand with epiglottitis. A flexible fiber-optic tube might also be used to look down the throat (general anesthesia would help keep your child comfortable).