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| |    When to Suspect Strep Throat: An Overview by Dr. Ed Kaplan reviewed by Lynn Cates, M.D., F.A.A.P. You probably already know that strep can cause a sore throat and fever, but it can be hard to tell whether your child has strep or another kind of sore throat. Although you may hear that seeing white pus spots on the tonsils means you are dealing with strep, in fact, the diagnosis of strep cannot be made just from looking at a child. For that reason, you should always consult your child's healthcare provider if you suspect strep. That said, some children do have signs and symptoms that are strongly suggestive of strep infections of the throat (strep pharyngitis) or tonsils (strep tonsillitis). Symptoms suggestive of strep throat in school-age children Symptoms that may help you recognize you are not just dealing with a routine viral respiratory tract infection (e.g., a cold) in a school-age child include:
Symptoms suggestive of strep throat in toddlers In younger children (infants and toddlers), the onset of infection usually is less obvious than in older children.
Symptoms that are uncommon with strep throat Respiratory tract symptoms such as cough, sneezing, runny nose, and a low-grade temperature of 99 or 100 are uncommon with strep infections. Children with these symptoms usually do not have streptococci in their throats unless, coincidentally, they happen to be a streptococcal carrier. Similarly, diarrhea is not characteristic of group A streptococcal infections. Infections that look like strep throat Some of the other infections that may be confused with streptococcal sore throat and tonsillitis in children (and, sometimes, in adults) include infectious mononucleosis (mono), ear infections (particularly in younger children), and a number of viral respiratory infections. Diphtheria used to be included, but this disease is extraordinarily uncommon in the United States at the present time. Outbreaks of diphtheria are occurring in other parts of the world (such as countries of the former Soviet Union), so diphtheria should be considered in children with a history of travel or exposure to travelers. Diagnosis and treatment of strep throat If you suspect that your child may have a strep infection, you should contact your child's healthcare provider. Because it is difficult to make the diagnosis of strep throat based on your child's signs and symptoms alone, her healthcare provider usually will want to confirm the presence or absence of these bacteria with a throat culture or rapid strep test. If the bacteria are not confirmed to be present, it virtually eliminates the need for antibiotics. If they are found, it is important that antibiotic treatment (usually with penicillin) be started, and that the entire course of treatment be completed to prevent long-term complications of strep throat such as rheumatic fever.
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