Sore throat is a very common reason for children to visit the doctor. Most sore throats are caused by viruses and require only comfort care. Parents often worry that their child’s symptoms are from strep throat and require antibiotics. While the only way to confirm that a sore throat is from strep, not all sore throats need a strep test.
How can you tell it’s strep?
There are some clues that a sore throat may be caused by strep bacteria.
1) Strep does not cause cold symptoms. Children with cough and congestion almost never have strep throat.
2) Fever. While both viruses and strep can cause fever, a high fever may be a clue that your child has strep.
3) Swollen lymph nodes. Tender, swollen lymph nodes in the neck often accompany strep throat.
4) Exudates. Those yucky white spots on the tonsils are more common in strep throat, although they can also be seen with viruses like mono and adenovirus.
If your child has some of these signs and symptoms, a strep test may be in order. A test should always be done if strep is suspected because even with all of the four signs listed, there is still only a 50/50 chance it’s strep.
If your child’s sore throat does not fit this picture, it is very likely from a virus, and they probably do not need a strep test. They should have comfort care at home – fluids, rest, over the counter pain relievers, and soft foods.
What’s the harm in just doing the test anyway?
Between 10-15% of children are strep carriers. That means they have a small amount of strep bacteria in their mouths and throats as a part of the mix of normal bacteria that live there. Any time these kids are tested for strep, it will come back positive, even if they are sick from a virus or if they are completely well. Testing all sore throats for strep results in many unneeded prescriptions for antibiotics which can cause unnecessary side effects like allergic reactions and stomach upset as well as risk of resistant infections in the future.
If your child’s symptoms are suspicious for strep or if you aren’t sure, call the office for an appointment.
Is sore throat ever an emergency?
Sore throats can usually wait for the office to open. In fact, it’s even safe to wait a few days to treat strep throat with antibiotics. You should seek emergency care if your child is having difficulty breathing or swallowing, or if he or she is drinking so little that you are worried they are becoming dehydrated.
Here is more information from the American Academy of Pediatrics.
