Your child wakes up in the morning and says, “My throat hurts.” He had complained yesterday as well. You feel his forehead and it is hot. You think, could it be strep throat? You rush to the phone and call your pediatric healthcare office to schedule an appointment.
Pharyngitis is an inflammation of the throat or sore throat. Pharyngitis may be caused by viruses or bacteria. Most sore throats are viral. Viral sore throats often include a fever, runny nose, or cough. Viral illnesses do not respond to antibiotic therapy and must run their course. Most viral sore throats will last 7-10 days and resolve without treatment.
Strep throat generally presents with a sudden sore throat accompanied by painful swallowing and may include fever, headache, and bellyache. There may be nausea and vomiting. It is more common in children aged 5 to 15 years but can occur in other ages and adults. You generally do not see cough, runny nose, hoarseness, mouth sores, or pink eye with strep throat. Strep throat may have a rough red rash that feels like sandpaper. This red rash forms across the chest, face, or arms. Since strep throat is often accompanied by fever, this rash is called scarlet fever or a scarlatina rash.
Group A Streptococcus is the bacteria that causes strep throat. Strep is spread from person to person through droplets that travel in the air through coughing or sneezing. You can also catch it by touching the droplets and then touching your mouth or nose. After exposure, it usually takes 2-5 days to get sick. Crowded conditions such as schools can increase the risk of illness. To protect your child: avoid contact with sick people, cover sneezes and coughs, wash hands frequently, and do not share drinks or utensils.
If you are concerned that your child might have strep throat, see your pediatric healthcare provider. He or she will take a detailed history, do a complete physical exam, and order a rapid strep test. Strep throat should not be diagnosed by examination but requires lab testing.
The rapid test involves a quick swab of the throat with a clean cotton swab. The strep test may make your child gag. You may be asked to hold your child during the test. Results can be obtained in just 10-15 minutes; however, the rapid test can miss some cases. A negative rapid strep test should be followed by a throat culture which is sent to the lab.
If either the rapid strep test or the lab throat culture is positive, it means that your child has strep throat. Strep throat is a bacterial infection which must be treated with antibiotics. Your pediatric healthcare provider will prescribe a course of antibiotics, usually penicillin or amoxicillin. If your child is allergic to penicillin, a cephalosporin may be substituted. Be sure that your child finishes the complete course of antibiotics provided.
The antibiotics will cure the strep infection, reduce the symptoms, and decrease the spread of illness. It also can prevent more serious complications from untreated strep throat such as kidney disease (post-strep glomerulonephritis) or heart disease (Rheumatic fever). Finishing a complete course of antibiotics can prevent these complications in children. Your child can return to school or daycare after he or she has been fever-free (off Tylenol or Motrin) and on antibiotics for at least 24 hours.
Most cases of sore throat are viral in nature, but strep throat must be considered. Contact your healthcare professional to schedule a sick visit to check for strep throat. If your child has strep throat, treat it completely to prevent complications. Do not let a sore throat turn into something much more serious.