Sore throat resident survival guide (pediatrics)
Synonyms and keywords:

# Overview
Sore throat is an acute upper respiratory tract infection that affects the respiratory mucosa of the throat.

# Causes
if left untreated cause acute rheumatic fever (ARF), According to WHO, at least 15.6 million people have rheumatic heart disease (RHD), and 233 000 deaths annually are directly attributable to ARF. Due to the limitations of reports related to limited resources in developing countries, it is likely that the prevalence and incidence of ARF are largely underestimated.

## Life Threatening Causes
Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.
- Croup
- Acute epiglottitis

## Common Causes

## Bacteria
- Streptococcus( group A beta-haemolytic ) most commonly 
- Haemophilus influenzae
- Moraxella catarrhalis

## viruses
- Rhinovirus
- coronavirus.
- respiratory syncytial virus.
- metapneumovirus.
- EpsteinBarr virus.

## chemical irritation
- nasogastric tubes.
- smoke.

# FIRE: Focused Initial Rapid Evaluation
=== Table 1===
Clinical signs and symptoms of GABSH pharingitis , their sensitivity and specificity
=== Table 2===
Clinical Score for GABSH pharyngitis.
=== Table 3 ===
Centor Score,

# Complete Diagnostic Approach"portal.nnpbc.com" (PDF)..mw-parser-output cite.citation{font-style:inherit}.mw-parser-output q{quotes:"\"""\"""'""'"}.mw-parser-output code.cs1-code{color:inherit;background:inherit;border:inherit;padding:inherit}.mw-parser-output .cs1-lock-free a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-limited a,.mw-parser-output .cs1-lock-registration a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-subscription a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration{color:#555}.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration span{border-bottom:1px dotted;cursor:help}.mw-parser-output .cs1-hidden-error{display:none;font-size:100%}.mw-parser-output .cs1-visible-error{display:none;font-size:100%}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration,.mw-parser-output .cs1-format{font-size:95%}.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-right{padding-right:0.2em}
- Rapid strep test (if available)
- Throat swab for culture and sensitivity
- If the child is greater than 2 years old, culture the throat before treatment or do rapid Strep antigen test (if available); if negative, do throat culture.
- Monospot if suspect vira

# Treatment 
A sore throat caused by a viral infection usually lasts five to seven days and doesn't require medical treatment"portal.nnpbc.com" (PDF)..
To ease pain and fever, many people turn to acetaminophen  may be given every four to six hours as needed but should not be given more than five times in a 24-hour period.,) or other mild pain relievers..
if  bacterial infection first choice treatment is penicillin ,  since GABHS remains universally susceptible to penicillin. Although penicillin V is the drug of choice, ampicillin or amoxicillin are good taste, represent a suitable option in children.
=== Table 4===
Therapeutic options for GABHS pharyngitis recommended by American Hearth Association and American Academy of Pediatrics AAP .
- Patients with immediate or type I hypersensitivity to penicillin should not be treated with a cephalosporin .

# Do's
- Pain reliever :Throat pain can be treated with a mild pain reliever such as acetaminophen ( Tylenol) or a nonsteroidal anti-inflammatory agent such as ibuprofen ( Advil, Motrin)
- keep hydration:Drinking alot  of fluid To reduce the risk of dehydration, parents can offer warm or cold liquids.
- Other intervention: include sipping warm beverages (eg, honey or lemon tea, chicken soup), cold beverages, or eating cold or frozen desserts (eg, ice cream, popsicles). These treatments are safe for children

# Don'ts
- Aspirin is not recommended for children <18 years due to the risk of a potentially serious condition known as Reye syndrome.
- Sprays containing topical anesthetics are available to treat sore throat  We do not recommend throat sprays for children.
- medicated throat lozenges are available to relieve dryness or pain it is not clear that lozenges work any better than hard candy. We do not recommend throat lozenges for children, especially children younger than five years, who can choke. Sucking on hard candy may provide some relief for children older than five years, who are not at risk for choking
- Honey should not be given to children younger than 12 months due to the potential risk of botulism poisoning.