Strep Throat Infection

Is this your child's symptom?

  • Your child was diagnosed with a Strep throat infection
  • A doctor has told you your child probably has Strep throat or
  • Your child has a positive Strep test
  • Your child is taking an antibiotic for Strep throat and you have questions
  • You are worried that the fever or sore throat is not getting better fast enough

Symptoms of Strep Throat Infection

  • Pain, discomfort or raw feeling of the throat
  • Pain is made worse when swallows
  • Children less than 2 years of age usually can't complain about a sore throat. A young child who does not want favorite foods may have a sore throat. They may also start to cry during feedings.
  • Other symptoms include sore throat, fever, headache, stomach pain, nausea and vomiting.
  • Cough, hoarseness, red eyes, and runny nose are not seen with Strep throat. These symptoms point more to a viral cause.
  • Scarlet fever rash (fine, red, sandpaper-like rash) is highly suggestive of Strep throat.
  • If you look at the throat with a light, it will be bright red. The tonsil will be red and swollen, often covered with pus.
  • Peak age: 5 to 15 years old. Not common under 2 years old unless sibling has Strep.

Cause of Strep Throat

  • Group A Strep is the only common bacterial cause of a throat infection. The medical name is Strep pharyngitis.
  • It accounts for 20% of sore throats with fever.
  • Any infection of the throat usually also involves the tonsils. The medical name is Strep tonsillitis.

Diagnosis of Strep Throat

  • Diagnosis can be confirmed by a Strep test on a sample of throat secretions.
  • There is no risk from waiting until a Strep test can be done.
  • If your child has cold symptoms too, a Strep test is usually not needed.

Prevention of Spread to Others

  • Good hand washing can prevent spread of infection.

When to Call for Strep Throat Infection

When to Call for Strep Throat Infection

Call 911 Now

  • Severe trouble breathing (struggling for each breath, can barely speak or cry)
  • Fainted or too weak to stand
  • Purple or blood-colored spots or dots on skin with fever
  • You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

  • Trouble breathing, but not severe
  • Great trouble swallowing fluids or spit
  • Stiff neck or can't move neck like normal
  • Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears.
  • Fever over 104° F (40° C)
  • Will not drink or drinks very little for more than 8 hours
  • Can't open mouth all the way
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Urine is pink or tea (brown) color
  • Taking antibiotic more than 24 hours, and sore throat pain is severe. The pain is not better 2 hours after taking pain medicines.
  • Taking antibiotic more than 48 hours and fever still there or comes back
  • Taking antibiotic more than 3 days and other Strep symptoms not better
  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Strep throat infection on antibiotic with no other problems

Call 911 Now

  • Severe trouble breathing (struggling for each breath, can barely speak or cry)
  • Fainted or too weak to stand
  • Purple or blood-colored spots or dots on skin with fever
  • You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

  • Trouble breathing, but not severe
  • Great trouble swallowing fluids or spit
  • Stiff neck or can't move neck like normal
  • Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears.
  • Fever over 104° F (40° C)
  • Will not drink or drinks very little for more than 8 hours
  • Can't open mouth all the way
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Urine is pink or tea (brown) color
  • Taking antibiotic more than 24 hours, and sore throat pain is severe. The pain is not better 2 hours after taking pain medicines.
  • Taking antibiotic more than 48 hours and fever still there or comes back
  • Taking antibiotic more than 3 days and other Strep symptoms not better
  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Strep throat infection on antibiotic with no other problems

Care Advice for a Strep Throat Infection

  1. What You Should Know About Strep Throat:
    • Strep causes 20% of throat and tonsil infections in school age children.
    • Viral infections cause the rest.
    • Strep throat is easy to treat with an antibiotic.
    • Complications are rare.
    • Here is some care advice that should help.
  2. Antibiotic by Mouth:
    • Strep infections need a prescription for an antibiotic.
    • The antibiotic will kill the bacteria that are causing the Strep throat infection.
    • Give the antibiotic as directed.
    • Try not to forget any of the doses.
    • Give the antibiotic until it is gone. Reason: To stop the Strep infection from flaring up again.
  3. Sore Throat Pain Relief:
    • Age over 1 year. Can sip warm fluids such as chicken broth or apple juice. Some children prefer cold foods such as popsicles or ice cream.
    • Age over 6 years. Can also suck on hard candy or lollipops. Butterscotch seems to help.
    • Age over 8 years. Can also gargle. Use warm water with a little table salt added. A liquid antacid can be added instead of salt. Use Mylanta or the store brand. No prescription is needed.
    • Medicated throat sprays or lozenges are generally not helpful.
  4. Pain Medicine:
    • To help with the pain, give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil).
    • Use as needed.
  5. Fever Medicine:
    • For fevers above 102° F (39° C), give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil).
    • Note: Fevers less than 102° F (39° C) are important for fighting infections.
    • For all fevers: Keep your child well hydrated. Give lots of cold fluids.
  6. Fluids and Soft Diet:
    • Try to get your child to drink adequate fluids.
    • Goal: Keep your child well hydrated.
    • Cold drinks, milk shakes, popsicles, slushes, and sherbet are good choices.
    • Solids. Offer a soft diet. Also avoid foods that need much chewing. Avoid citrus, salty, or spicy foods. Note: Fluid intake is much more important than eating any solids.
    • Swollen tonsils can make some solid foods hard to swallow. Cut food into smaller pieces.
  7. What to Expect:
    • Strep throat responds quickly to antibiotics.
    • The fever is usually gone by 24 hours.
    • The sore throat starts to feel better by 48 hours.
  8. Return to School:
    • Your child can return to school after the fever is gone.
    • Your child should feel well enough to join in normal activities.
    • Children with Strep throat need to be taking an antibiotic for at least 12 hours.
  9. Call Your Doctor If:
    • Trouble breathing or drooling occurs
    • Dehydration suspected
    • Fever lasts more than 2 days after starting antibiotics
    • Sore throat lasts more than 3 days after starting antibiotics
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.

Reviewed: 10/11/2023 Updated: 1/31/2023

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