Should Your Child See a Doctor?

Strep Throat Infection

Is this your child's symptom?

  • A bacterial infection of the throat caused by Strep
  • A doctor has told you your child probably has Strep throat or
  • Your child has a positive Strep test
  • Your child is taking an antibiotic for Strep throat
  • You are worried that the fever or sore throat is not getting better fast enough

If not, try one of these:

Symptoms of Strep Throat Infection

  • Pain, discomfort or raw feeling of the throat
  • Pain is made worse when child swallows
  • Children less than 2 years of age usually can't complain about a sore throat. A young child who does not want favorite foods may have a sore throat. They may also start to cry during feedings.
  • Other symptoms include sore throat, fever, headache, stomach pain, nausea and vomiting.
  • Cough, hoarseness, red eyes, and runny nose are not seen with Strep throat. These symptoms point more to a viral cause.
  • Scarlet fever rash fine, red, sandpaper-like rash is highly suggestive of Strep throat.
  • If you look at the throat with a light, it will be bright red. The tonsil will be red and swollen, often covered with pus.
  • Peak age: 5 to 15 years old. Not common under 2 years old unless sibling has Strep.

Cause of Strep Throat

  • Group A Strep is the only common bacterial cause of a throat infection. The medical name is Strep pharyngitis.
  • It accounts for 20% of sore throats with fever.
  • Any infection of the throat usually also involves the tonsils. The medical name is Strep tonsillitis.

Diagnosis of Strep Throat

  • Diagnosis can be confirmed by a Strep test on a sample of throat secretions.
  • There is no risk from waiting until a Strep test can be done.
  • If your child has cold symptoms too, a Strep test is usually not needed.

Prevention of Spread to Others

  • Good hand washing can prevent spread of infection.

Call 911 Now (Your Child May Need an Ambulance) If

 

  • Severe trouble breathing struggling for each breath, can barely speak or cry
  • Fainted or too weak to stand
  • You think your child has a life-threatening emergency

Call Doctor Now or Go to ER

  • Trouble breathing, but not severe
  • Great trouble swallowing fluids or spit
  • Stiff neck or can't move neck like normal
  • Dehydration suspected. No urine in over 8 hours, dark urine, very dry mouth and no tears
  • Purple or blood-colored spots or dots on skin
  • Fever over 104° F 40° C
  • Will not drink or drinks very little for more than 8 hours
  • Can't open mouth all the way
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Urine is pink or tea brown color
  • Taking antibiotic more than 24 hours, and sore throat pain is severe. The pain is not better 2 hours after taking pain medicines
  • Taking antibiotic more than 48 hours and fever still there or comes back
  • Taking antibiotic more than 3 days and other Strep symptoms not better
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Strep throat infection on antibiotic with no complications

Care Advice for a Strep Throat Infection

  1. What You Should Know About Strep Throat:
    1. Strep causes 20% of throat and tonsil infections in school age children.
    2. Viral infections cause the rest.
    3. Strep throat is easy to treat with an antibiotic.
    4. Complications are rare.
    5. Here is some care advice that should help.
     
  2. Antibiotic by Mouth:
    • Strep infections need a prescription for an antibiotic.
    • The antibiotic will kill the bacteria that are causing the Strep throat infection.
    • Give the antibiotic as directed.
    • Try not to forget any of the doses.
    • Give the antibiotic until it is gone. Reason: To stop the Strep infection from flaring up again.
     
  3. Sore Throat Pain Relief:
    • Age over 1 year. Can sip warm fluids such as chicken broth or apple juice.
    • Age over 6 years. Can also suck on hard candy or lollipops. Butterscotch seems to help.
    • Age over 8 years. Can also gargle. Use warm water with a little table salt added. A liquid antacid can be added instead of salt. Use Mylanta or the store brand. No prescription is needed.
    • Medicated throat sprays or lozenges are generally not helpful.
     
  4. Pain Medicine:
    • To help with the pain, give an acetaminophen product such as Tylenol.
    • Another choice is an ibuprofen product such as Advil.
    • Use as needed.
     
  5. Fever Medicine:
    • For fevers above 102° F 39° C, give an acetaminophen product such as Tylenol.
    • Another choice is an ibuprofen product such as Advil.
    • Note: Fevers less than 102° F 39° C are important for fighting infections.
    • For all fevers: Keep your child well hydrated. Give lots of cold fluids.
     
  6. Fluids and Soft Diet:
    • Try to get your child to drink adequate fluids.
    • Goal: Keep your child well hydrated.
    • Cold drinks, milk shakes, popsicles, slushes, and sherbet are good choices.
    • Solids. Offer a soft diet. Also avoid foods that need much chewing. Avoid citrus, salty, or spicy foods. Note: Fluid intake is much more important than eating any solids.
    • Swollen tonsils can make some solid foods hard to swallow. Cut food into smaller pieces.
     
  7. What to Expect:
    • Strep throat responds quickly to antibiotics.
    • The fever is usually gone by 24 hours.
    • The sore throat starts to feel better by 48 hours.
     
  8. Return to School:
    • Your child can return to school after the fever is gone.
    • Your child should feel well enough to join in normal activities.
    • Children with Strep throat need to be taking an antibiotic for 24 hours.
     
  9. Call Your Doctor If:
    • Trouble breathing or drooling occurs
    • Dehydration suspected
    • Fever lasts more than 2 days after starting antibiotics
    • Sore throat lasts more than 3 days after starting antibiotics
    • You think your child needs to be seen
    • Your child becomes worse
     

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Copyright 1994-2015 Barton D. Schmitt, MD. All rights reserved.