While the weather has been hot lately, many children have come to the outpatient clinic with acute sore throat. Parents always think that their children probably have a cold, but a sore throat is not the same as a cold. What we call a cold is an acute viral infection of the upper respiratory tract. One-third of the patients have a sore throat, or acute pharyngitis, but there are many causes of acute pharyngitis.
急性咽炎是指咽部的急性發炎，包括紅斑、水腫、滲液、潰瘍或水泡。咽炎可能與環境暴露有關，如香菸、空氣污染、過敏原、腐蝕性物質、熱食、熱湯和傳染性病原體。
Acute pharyngitis is an acute inflammation of the pharynx that includes erythema, edema, oozing, ulcers or blisters. Pharyngitis may be associated with environmental exposures such as cigarette smoke, air pollution, allergens, corrosive substances, hot foods, hot soups and infectious agents.
病毒是急性咽炎的主要原因，常通透過口腔接觸或飛沫傳染，常發生在秋天至春天。可能引起急性咽炎的病毒包括：鼻病毒、呼吸道融合病毒、冠狀病毒、腸病毒、流感病毒、腺病毒、EB病毒、巨細胞病毒、單純皰疹病毒。大多數病毒引起的咽炎常在後來伴隨流鼻水或咳嗽症狀，另外，病毒性染也易導致細菌性中耳感染和細菌性鼻竇炎。對多數病毒引起的咽炎採症狀治療，包括退燒和止痛藥物。麻醉噴霧劑可以提供局部緩解作用。雖然類固醇常用於患有咽炎的成人，但在兒童身上仍缺乏大規模研究在安全性和療效性的證實。
Viruses are the main cause of acute pharyngitis, which is often transmitted through oral contact or droplet infection and often occurs in the fall to spring. Viruses that may cause acute pharyngitis include: rhinovirus, respiratory fusion virus, coronavirus, enterovirus, influenza virus, adenovirus, EBV, cytomegalovirus, and herpes simplex virus. Most viral pharyngitis is often followed by a runny nose or cough, and viral infections can also lead to bacterial middle ear infections and bacterial sinusitis. Symptomatic treatment for most viral pharyngitis includes medications to reduce fever and relieve pain. Anesthetic sprays can provide local relief. Although steroids are commonly used in adults with pharyngitis, there is a lack of large-scale studies in children to confirm safety and efficacy.
細菌引起的急性咽炎不容忽視，特別是A型鏈球菌。鏈球菌咽炎在二至三歲前相對少見，在五至十五歲兒童卻相當常見。全年都有機會感染，其中冬天至春天最為普遍。腹瀉、咳嗽、流鼻水、潰瘍、聲音嘶啞、結膜炎與鏈球菌性咽炎無關，若有以上症狀，應懷疑病毒感染引起。鏈球菌咽炎採用抗生素治療，早期抗生素治療能加速恢復十二至二十四小時，減少化膿或併發症，以及預防急性風濕熱。
Acute pharyngitis caused by bacteria, especially Streptococcus A, should not be ignored. Streptococcal pharyngitis is relatively uncommon before the age of 2 to 3 years, but is quite common in children aged 5 to 15 years. It is a year-round infection, with winter to spring being the most common. Diarrhea, cough, runny nose, ulcers, hoarseness, and conjunctivitis are not associated with streptococcal pharyngitis, but viral infection should be suspected. Streptococcal pharyngitis is treated with antibiotics. Early antibiotic therapy speeds recovery by 12 to 24 hours, reduces suppuration or complications, and prevents acute rheumatic fever.
