Strep/Sore Throat

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Author: Nicole Marty, MD

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My child has a sore throat, how do I know if it is strep throat?

It is important to remember that viruses are by far the most common cause of a sore throat. Antibiotics will NOT work to treat a virus.  Viral sore throats can feel just as bad if not worse than strep throat.

Symptoms of true strep throat include the following:

• No other symptoms besides a sore throat and fever (and sometimes upset stomach) - If your child has a sore throat and cough, runny nose, sneezing or congestion, the sore throat is less likely to be caused by strep and more likely to be due to a virus.
• Very red throat with red spots and/or pus on the tonsils (although some viruses can also look this way).
• Fine pink rash on the chest, abdomen, and back which feel like sandpaper when you run your fingers over it. It may look like a sunburn.
• Known close exposure to someone with strep throat.

Symptoms of a viral sore throat

• Throat pain only when coughing but not when swallowing
• Multiple cold or flu symptoms such as a cough, runny nose, watery eyes, sore muscles and sneezing
• The child is not acting very sick overall

If my child has strep throat, does he/she need to start antibiotics right away (do I need to bring the child to urgent care/ER right now)?

Many parents worry that if they don't start antibiotics right away it will cause harm to their child in the long or short term. However, studies have shown that it is safe to wait several days before starting antibiotic therapy without any increased risk for complications.

Although there is no harm in taking your child to urgent care, it is safe to wait until the next day to call the office and see your regular pediatrician for a throat swab. However, it is important to remember that if your child seems severely ill you need to bring them to the ER or Urgent Care right away. If you notice the following signs or symptoms, you need to bring your child to care urgently:

• Trouble breathing
• Can't swallow fluids or has new onset of drooling
• Stiff neck or can't move neck like normal
• Purple or blood-colored spots on the skin
• You suspect your child may be dehydrated (No urine in over 8 hours, dry mouth, no tears, dark urine)
• Child is lethargic
• Fever over 104

What can I do at home to help my child feel better?

There are many things you can do at home to help your child feel better either before or after your child has seen their provider.

• The best way to treat throat pain is to give the child ibuprofen or Tylenol. In our experience, ibuprofen often works the best (do not give ibuprofen to a child under 6 months of age).
• Sip on warms fluids such as chicken broth.
• If the child is old enough to gargle and spit you can add a little table salt to warm water and have them gargle with this mixture.
• Make sure your child stays hydrated by drinking adequate fluids. Foods like popsicles, slushes, sherbet, and ice cream also contain fluids and can soothe a sore throat.