Is it Strep Throat?

Influenza is finally dying down, but lately, we have seen a run of strep throat in our Methodist Physicians Clinic Regency pediatrics office. If your child complains of a sore throat, how can you tell the difference between just a run-of-the-mill virus and strep?

What is strep?

Strep throat is a contagious disease caused by infection with streptococcal bacteria. That bacteria causes the mucous membranes lining the back of the throat and the tonsils to become swollen and inflamed. It’s a common cause of sore throat in school-aged children and teens, and should be diagnosed and treated quickly to avoid any potential complications.

What are the signs of strep?

Common symptoms of strep throat include:

• Very sore throat, to the point where it feels like you are swallowing glass or something sharp with every swallow
• Fever
• Headache
• Stomach ache
• Vomiting
• Fine, pink, sandpaper-like rash on the chest, back, abdomen and sometimes spreading onto the face

Strep throat often appears with very swollen tonsils at the back of the throat. The tonsils are often red, inflamed and may be coated with white or yellow pus. You may also see some bruising or purple spots on the roof of the mouth. Children often will have swollen lymph nodes in the neck which may be tender. 

How do you diagnose strep?

We diagnose strep throat in a patient by history, physical exam and the dreaded strep test. Two long cotton swabs are inserted into the patient’s mouth and tickle the back of his throat and tonsils. We often collect two swabs. One swab is for the rapid strep test and the second is for the backup culture. 

The rapid test is about 95 percent accurate. If the rapid strep test is negative, we will watch the second swab culture for 24-48 hours to see if it turns positive.

If the strep test is positive, we treat the patient with 10 days of antibiotics. A patient is considered contagious until he has been on antibiotic for 24 hours. 

Strep can be very contagious. I recommend no sharing drinks, kisses or close contact until the child is no longer considered contagious. 

If it is not strep, what could it be?

Most cases of sore throat are in fact due to a viral infection, so it could be a virus. Strep throat symptoms often occur in isolation, so if the child has stuffy nose, cough, congestion of the nose or chest, a virus is more likely. An antibiotic will not help a viral infection.

It could also be an allergy. Despite the temperatures, trees and grasses have started to bud and bloom. Runny nose, itchy eyes, throat clearing and post nasal drainage may accompany the start of spring allergies. 

Stopping strep

Good hand washing and keeping our hands out of our mouths and noses is good practice. If you have questions, or believe this could be strep in your little one, call your Methodist Physician’s Clinic primary care provider’s office to discuss.