Strep Throat – More Than Just a “Sore Throat”
Kids get sore throats for many reasons – irritation from post-nasal drainage, allergies, abrasions from sharp foods, viral infections, and bacterial infections. Most of these are self-limited. They cause pain and discomfort for few to several days, but go away eventually without much intervention. Strep is a more serious cause of throat pain, and usually starts very suddenly. It is accompanied by fever, swelling of the lymph nodes in the throat, and difficulty swallowing. It usually does not cause cough.
What causes Strep throat?
A particular bacteria, called group A Streptococcus, or group A strep, causes Strep throat. This particular bacteria lives in the nose and throat and spread easily between close contacts. This occurs through coughing, sneezing, and sharing of drinks or utensils.
Infection with group A strep usually produces a characteristic appearance to the throat, with red, swollen tonsils (sometimes with white patches), and small bright red spots on the roof of the mouth. I say usually because not all children demonstrate these signs on examination even when the testing is positive. It often also causes headache, stomach pain, and nausea or even vomiting. It is much more common in children than in adults.
Group A strep is identified as the cause of a sore throat through a throat swab. This is done by rubbing a cotton swab on the tonsils and back of the throat. The swab is then tested in the lab for the presence of strep.
What is Scarlet Fever?
Though it strikes some fear into parents, Scarlet Fever is simply a strep infection accompanied by a rash. This is usually a rough, red rash composed of small red bumps that feel like sandpaper. It found on the chest, abdomen and sometimes extends down to the groin. Scarlet Fever does not cause more severe illness than Strep throat without a rash and it is treated exactly the same.
How is Strep throat treated?
Group A strep infections are treated with antibiotics. Amoxicillin is the antibiotic recommended for those who are not allergic to penicillins. Other choices are available for those with allergies. It is also important to change out a child’s toothbrush after starting antibiotics to avoid reinfection.
Antibiotics work quickly to decrease symptoms, prevent spread of infection to others, and decrease duration of illness, and decrease complications of infection.
Are there complications?
Yes, there are sometimes complications due to infections with group A strep. This is usually due to the bacteria spreading to other parts of the body before antibiotics can take effect, however they can also be caused due to an inflammatory response by the body after the initial infection. These complications include the following:
- sinus infections
- ear infections
- abscesses (deep pockets of pus under the surface) of the tonsils
- Kidney disease, called post-streptococcal glomerulonephritis
- Rheumatic fever
What is Rheumatic Fever?
Rheumatic fever can develop if Strep throat is not treated properly with antibiotics. It is an inflammatory disease that can affect the joints, brain, skin, and heart. It is not contagious. It is commonly characterized by fever, painful and tender joints (knees, ankles, elbows, and wrists), fatigue, uncontrolled body movements (“chorea”). It can also lead to a new heart murmur due to damage to one of the heart valves. This causes enlargement of the heart and even congestive heart failure and death.
While this complication is more rare in the United States where group A strep infection is usually quickly identified and treated, it is still fairly common in some developing countries where access to health care is limited.
When to worry
Strep throat is one of the most common infections in childhood, but still deserves proper medical attention. If your child experiences a sore throat accompanied by fever, swollen lymph nodes in the throat, and lack of other cold symptoms such as congestion or cough, he or she should be evaluated by a Pediatrician. It will be important to check for the possibility of group A strep as the cause of infection. Prompt recognition and treatment will prevent spread of infection within the family, decreased duration of symptoms in your child, and prevent complications like Rheumatic fever.
