School’s starting up again, and with that comes multiple viruses and bacterial infections, including the dreaded strep throat. We chatted with Kathryn O’Malley, M.D., F.A.A.P., from Muddy Creek Pediatrics, on the basics of strep throat. We also learned (as will you) about why it’s important to treat strep with antibiotics and to complete the full course of treatment, i.e. don’t let that pink bubblegum medicine get lost in the back of your refrigerator!
Cincinnati Family: What makes Strep throat different from other infections like tonsillitis?
Kathryn O’Malley: Tonsillitis (inflammation of the tonsils) can be caused by either viruses or bacteria. Most sore throats are caused by viruses. Streptococcus Group A is the most common bacterial cause, and about three out of 10 children with a sore throat will have strep. Sore throats caused by viruses do not need antibiotics. Sore throats caused by bacteria require antibiotics. Strep is most common in school-age children.
CF: What symptoms should parents watch for and at what point should the child see a doctor?
KO: Parents should watch for moderate to severe sore throat, a fever of at least 101 degrees Fahrenheit, swollen glands in the neck, not wanting to eat or drink anything and vomiting.
Sometimes you can see redness in the back of the throat. Sore throats caused by viruses typically have other respiratory, cold-like symptoms like a runny nose, cough, hoarse voice and red watery eyes. Unfortunately, it’s hard to tell the difference between sore throats caused by viruses and Strep throat (even for the doctor!) because the symptoms overlap a lot. White spots (exudate) on the tonsils can be associated with both Strep pharyngitis and viral pharyngitis. Only testing can definitively give a real answer: either an overnight throat culture, or a rapid antigen test followed by an overnight throat culture if the rapid test is negative.
If your child has fever and a sore throat, go to the doctor to check for strep throat (that day, if possible). If there is no fever and the sore throat has cold-like symptoms associated with it, wait two to three days and if not better or worsening, see the doctor.
Parents should take any child to the emergency room (or call an ambulance if severe) if he is having trouble breathing or swallowing/ choking on secretions, drooling excessively or having a stiff neck.
CF: What happens if strep throat goes untreated?
KO: It’s important to finish the entire course of antibiotics even if all symptoms are gone in the first day or two.
While Group A Strep can resolve on its own without treatment, the antibiotic reduces the length of the symptoms and helps reduce the spread of the germs to others.
Another goal of treatment is to reduce the risk of complications of
Streptococcus infections including tonsillar abscess, ear and sinus infections and necrotizing fasciitis (a severe, rapidly spreading infection of the soft tissue and muscles around the neck).
Other possibly severe complications of untreated Strep are acute rheumatic fever that can lead to permanent heart damage, Strep toxic shock syndrome, inflammation of the kidneys (Strep-induced glomerulonephritis), and pediatric autoimmune neuropsychiatric disorder associated with group A streptococci (PANDAS).
GET A CLOSER LOOK
throatscope.com | $19.99
Handy and easy to use, this tongue depressor will illuminate the back of your child’s throat with it’s built-in light. It has a re-useable handle and detachable depressor. Makes it easy to see a red throat or even white spots that could indicate strep.