Pharyngitis is an infection of the throat. Tonsillitis is an infection of the tonsils, a more complicated form of pharyngitis. Symptoms include sore throat, pain on swallowing, redness of the throat, enlargement of the tonsils and lymph nodes ("glands") of the neck, whitish patches in the throat and on the tonsils, fever, fatigue, and occasionally ear discomfort. Both infections may be caused by bacteria or by viruses. Physical examination alone is not sufficient to diagnose the cause of infection. If bacterial, the most common cause is Streptococcus ("strep"). Screening tests are therefore performed to determine the presence or absence of strep. A test may be done in the office or sent to the lab. If cultured, preliminary results are generally available in 1 to 3 days. If tests for bacteria fail to show a causative organism, the infection is assumed to be viral. Antibiotics are curative if the infection is bacterial. Antibiotics are ineffective in viral infections. Most cases of pharyngitis resolve in 5-10 days. Persistent symptoms may require further evaluation.



Upper respiratory infections (URIs) are caused by many different viruses. Typical symptoms include sore throat, nasal congestion and discharge, cough, headache, muscle aches, fever, and fatigue. Medications may help improve your symptoms, but are not curative. Antibiotic therapy is ineffective in viral URIs as they are in any other viral infection. Occasionally bacteria may complicate URIs. Your doctor will check you for this bacterial "superinfection" and suggest antibiotic therapy if indicated.


  1. Rest. Activity may slow your recovery.
  2. Drink plenty of fluids. If you cannot eat solid foods because of pain, take high-calorie liquids such as milkshakes, ice cream, or commercial preparations such as Ensure or Merital.
  3. If you smoke, discontinue cigarettes.
  4. Gargle with antiseptic or warm salt water (1 tsp in 8 oz water) to soothe throat. Lozenges such as Sucrets, Hall's Mentholyptus, Chloroseptic, and Cepastat may help also.
  5. Advil or acetaminophen for fever and pain may be helpful.
  6. If prescription medications were given, take them as directed. TO CURE STREP INFECTIONS TEN DAYS OF ANTIBIOTIC THERAPY IS REQUIRED.
  7. If you had a throat culture performed, call the office in 2-3 days to obtain a report. Final reports may take as long as a week to return.
  8. If your symptoms persist longer than 7-10 days, make an appointment to return to the office for further evaluation.
  9. If you develop increasing fever, increasing throat pain, severe throat or tonsilar swelling, or difficulty breathing, headache, facial pain, stiff neck, ear pain, or progressive cough with colored phlegm, make an appointment to return to the office promptly for reevaluation.


Fever is a normal body reaction to viral or bacterial illness. Fevers up to 104 F are not unusual in children, but may make them uncomfortable.


1) Give appropriate doses of acetaminophen (Tylenol) every 4 hours. The use of aspirin in children with some viral infections has been associated with Reye Syndrome, a rare but severe condition. Therefore, use of acetaminophen is recommended for most cases. Do not exceed the recommended dose.

2) If fever is difficult to reduce, you may alternate acetaminophen and aspirin (Acet@4PM, Asp@6PM, Acet@8PM, Asp@10PM...). Be certain to read the package instructions carefully and use the proper dose for your child's weight.

3) Fluid loss occurs with fevers and therefore replacement fluids must be given. Offer the child liquids as often as he or she will take them. You may also give popsicles, soft drinks, fruit juices, water, Gatorade, or Pedialyte (available in drug or grocery stores).

4) Fevers above 104 F not responding to treatment, or other changes in your child's condition which concern you, should be brought to the attention of your pediatrician for further instructions or care.


Revised 9/08




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