When to Suspect Strep Throat in Your School-Age Child

August 30, 2008

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When to Suspect Strep Throat in Your School-Age Child

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 throat 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 school-age children 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:

Sudden and rapid onset of a severe sore throat with difficulty swallowing accompanied by a temperature which is usually greater than 101 degrees Fahrenheit

Other symptoms such as headache, nausea, vomiting, and abdominal pain

Swollen and tender lymph glands underneath the jaw and in the front and sides of the neck.

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 which 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.


RELATED INFORMATION

			Diagnosing Strep Throat
			Strep Infections

Created December 23, 2000
Reviewed February 24, 2001

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