Is It Strep Throat? Tips for Recognizing and Treating Strep Throat

When your child complains of a sore throat or pain while swallowing, you probably start wondering if it’s strep throat. 

Strep throat is a throat infection caused by a bacteria called Group A streptococcus. The bacteria can be spread from person to person through airborne droplets or saliva, such as when sharing food or drinks.

Common symptoms of strep throat

Strep can look different from person to person. While some kids might look fairly ill, others won’t be as bothered by symptoms. In addition to the standard sore throat and painful swallowing, some other signs and symptoms of strep throat may include:

• Tender, swollen lymph nodes (glands) in the front of the neck
• Red spots on the roof of the mouth or palate
• Swollen and red tonsils; white patches on occasion
• Fever
• Headache
• Nausea or vomiting and stomach pain  
• Fine sandpaper-like rash, also known as scarlet fever

Signs that it’s probably not strep

Strep throat typically does not cause a bad cough, profuse runny nose, ulcers in the throat, or laryngitis. If your child has these other symptoms in addition to a sore throat, you can be fairly sure they do NOT have strep.

Treating strep

If you suspect your child has strep throat, call your pediatrician.

Using Antibiotics Safely

Find out why antibiotics aren’t always the answer and how you can help prevent antibiotic resistance in your child.

If it is strep, your child will need an antibiotic to prevent complications. The good news: Within a day of taking the first dose of antibiotic, your child should begin to feel better, and once they are on antibiotics for over 12 hours, they are no longer contagious. However, be sure to finish the entire course of the antibiotic, even if your child feels better partway through the treatment.

Tips to soothe a child’s sore throat

Whether your child has strep or not, there are many ways to soothe a sore throat.

• Give age-appropriate pain medication such as acetaminophen (brand name Tylenol) or ibuprofen (brand names Advil or Motrin). Treat the pain as quickly and effectively as possible. Giving pain medicine will not interfere with physical exam findings or strep test results.
• Give lots to drink. See what brings your child the most relief — some prefer warm beverages, while others might get more relief from very cold or frozen drinks. Avoid citrus juices since they sometimes sting sore throats. When encouraging your child to drink, tell them that the first few sips may hurt but then the liquid will start to soothe their throat.
• Provide soft foods if your child is hungry. For example, noodles feel better than a hamburger on a sore throat. And ice cream or sherbet can be effective as well.
• Try honey (if your child is older than 1 year). Give 1 to 2 teaspoons of honey three times a day. Not only can it soothe a sore throat, but it also might quiet the cough that often accompanies a sore throat virus. Give it alone or mix it into milk or a warm drink.
• Have your child suck on lozenges containing pectin or menthol for relief (if your child is older than 5 years and doesn’t choke easily). Lozenges don’t replace hydration. Kids still need to drink fluids to stay hydrated.
• Gargle saltwater. To make this age-old remedy, mix 1 teaspoon of salt in 6 ounces of warm water, and have your child gargle it three times a day.

When to call or see a doctor for a sore throat

Short-term complications of strep throat include abscesses (pockets of pus) and, while rare, invasive infections. Bacteria like group A strep can move beyond the throat or skin and enter the bloodstream, lungs, fluid in the spinal cord, or other places inside the body where they would not typically live. Invasive group A strep infections are severe and can cause diseases like pneumonia, sepsis, toxic shock syndrome, and a serious skin and tissue infection called necrotizing fasciitis.

Longer term complications of strep throat include heart valve issues and kidney issues. If your child with strep throat shows the following, call or see a doctor:

• New or worsening symptoms
• Signs of dehydration such as dry lips and mouth, no tears on crying, urination less than every six hours, and lethargy
• Difficulty breathing
• Cannot swallow (may even spit out their own saliva or drool)
• Cannot open mouth fully
• Continued fever
• Muffled voice (like eating a hot potato)
• Neck swelling or stiffness

According to the Centers for Disease Control and Prevention (CDC), up to 30% of children with a sore throat have strep throat. Hopefully, your child is not one of them.