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Children's Health

2 year old with throat infection

09/29/2008

Question:

my daughter has a fever, blisters in the back of her throat, her gums are bright red, and look like they have white stripes on them. She refuses to eat or drink anything. The pediatrician tells me its a throat infection and gave antibiotics but i feel that it isnt helping much. what do you recommend. Do you think it could be something more serious?

Answer:

It is possible that your daughter does not have a bacterial throat infection which would be a good reason why the antibiotic is not helpful. Antibiotics only treat bacterial infections. I don't know if a throat swab was done for a rapid strep test or not, and if it was positive or negative. Usually if there is a positive test for strep, antibiotics bring quick relief. 

The most common viral causes of mouth sores, red and painful gums, sore throat and fever are Hand-Foot-and-Mouth Disease caused by Coxsackie virus, herpangina caused by another Coxsackie virus, and herpes gingivostomatitis that is caused by the herpes virus, and aphthous ulcer gingivostomatitis that is associated with the common cold. All of them cause painful lesions in the mouth and many children do refuse to eat. What is very helpful to many children is a mouth rinse with 1/2 Maalox or equivalent generic product liquid antacid and 1/2 liquid diphenhydramine (Benadryl). For example, 1 Tablespoon of liquid antacid to 1 Tablespoon liquid diphenhydramine well mixed. You can have the child swish and spit the solution or dab it on the gums and ulcers with cotton swabs. I usually use 2 or 3 to get a good coating on as quickly as possible.

Young children can dehydrate quickly. Eating is not nearly as important as drinking, so do try your best to get her to take liquids. Cold, sweet liquids are usually well tolerated because of the numbing effect of the cold liquid. Milk shakes, popsicles, cold apple juice, anything at all cold and not spicy or sour will do. These problems usually last anywhere from 3 days to two weeks.

If you really cannot get your child to drink fluids, you should let her doctor know. You should also observe her for signs of dehydration and take her to the nearest pediatric ER if you see them. These include a dry mouth and lips, sunken and/or dark circled eyes, lethargy or unresponsiveness, dry skin that can be pulled up and does not spring back immediately on the abdomen, lack of tears, urinating little or nothing.

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University