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Strep Throat
Strep Throat
What is strep throat?
While many people use the terms sore throat, tonsillitis, and strep throat interchangeably, there are significant differences between these conditions. Understanding the differences can give parents a better idea of how and when to be concerned and seek advice from the child's doctor.
Tonsils and tonsillitis
The tonsils are red, oval clumps of tissue located at the back and to the sides of the throat. This location allows the tonsils to intercept germs as they enter the child's body through the nose and throat. They contain infection-fighting cells and antibodies that stop the spread of the germs further into the body. When the tonsils become red, sore, and swollen, this inflammation is called tonsillitis. This is not a specific term, as there are many causes of tonsil inflammation.
Viral sore throat
In infants and children, the most common cause of tonsillitis is an infecting germ called a virus. For a viral infection, no antibiotic is usually needed and the infection can be expected to run a four-to-six day course. During this period, the child can be treated with lots of fluids, rest, and medicine to reduce pain and/or fever, such as acetaminophen (Tylenol, Tempra, Liquiprin, etc.) or ibuprofen (Motrin, Advil, etc.).
Bacterial sore throat
Bacterial causes of sore throat or tonsillitis can require further attention from parents and pediatricians. Streptococcus, or strep, is the most frequently found bacteria. This germ requires an antibiotic for rapid treatment. Antibiotics do not lower the body's immune system or make it "lazy." On the contrary, antibiotics work together with the normal, healthy infection-fighting immune system to make it more rapid and successful in killing bacteria like strep.
What are the symptoms of strep throat?
When the child's throat infection is caused by strep, the symptoms vary quite a bit depending on the child's age. Infants primarily experience a thick colorful nose drainage and possibly a low-grade fever, with a decrease in appetite. Children ages one to three ("toddlers") may complain of a sore throat, trouble swallowing, poor appetite (yes, even less appetite than normally seen at this age!), crankiness, and swollen glands beneath the jaws. Older children generally look and feel awful with strep throat! They can have high fevers, very painful throats, often severe difficulty swallowing, and pus which can sometimes be seen covering the tonsils. These complaints mean that the child should see the doctor right away, as distinguishing viral and bacterial causes of tonsil infection is very important in correctly treating the infection.
When should I be concerned about a possible strep throat?
Parents should be concerned about a sore throat that does not improve after a sip of water after arising from sleep , or one that is accompanied by a headache, high fever, stomach ache, vomiting, or severe tiredness. The presence of a red, somewhat rough-to-the-touch rash is also a concern, as strep infection along with a rash is known as scarlet fever (no more dangerous than strep throat without a rash, but this is a term that continues to strike fear into parents' hearts!). An urgent call to the doctor's office is appropriate if the child has extreme difficulty swallowing, causing drooling, or is having difficulty breathing.
How is strep throat detected by the doctor?
During the doctor's physical examination, a throat culture might be taken by touching a soft cotton swab to the throat and tonsil area. Germs from the swab are smeared onto a special plate and sent to the laboratory for evaluation of strep or other conditions. After twenty-four hours, the rapidly-growing germs associated with strep can be identified if present in the culture. There are also available rapid-strep tests that can give results in minutes. Taking any antibiotic prior to seeing the doctor should be avoided. Even a single dose of antibiotic can interfere with the culture results and your doctor's ability to correctly diagnose and treat the infection.
How is strep infection treated?
If a strep infection is detected, an antibiotic is prescribed. Antibiotics commonly used to treat strep throat infections include, among others, amoxicillin (Amoxil) and erythromycin (ERY PED, E.E.S.). It is important to take the full course of antibiotics as prescribed, and not stopping the medication when symptoms resolve. Prematurely discontinuing antibiotics can result in the infection being inadequately treated with potentially adverse consequences.
Why is it very important to detect and treat a strep throat?
The condition known as rheumatic fever is a disease that affects the joints and heart and is caused by untreated or inadequately treated strep infection. Rheumatic fever can cause disease of the heart valves. Fortunately, it is now uncommon in the current antibiotic era. Another complication that can occur after inadequately treated strep throat is a kidney inflammation called glomerulonephritis. This can cause decreased kidney function, and blood and protein in the urine.
How about having the tonsils taken out?
Surgical removal of the tonsils is much less common today thanks to the present ability to rapidly and accurately diagnose strep infection, and thanks to the excellent antibiotics currently available. Remember, antibiotics should never be shared! - A strep throat is caused by a bacteria (the streptococcus).
- Most other throat infections are caused by viruses.
- The symptoms of strep throat include fever, sore throat, and swollen lymph glands in the neck.
- The diagnosis of strep throat is confirmed by a throat culture or rapid-strep tests.
- Strep throat is best treated with antibiotics.
Last updated on 07/03/2008
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