Strep throat is more common in slightly older children and adolescents, with symptoms including a fever, sore throat, and swollen tonsils. A rapid strep test or throat culture is needed for diagnosis, and antibiotics are required for treatment.
Strep in young children is not as common, and slightly older children and adolescents are more vulnerable to the disease. Many of the symptoms across all age groups are the same, but children may not get so sick initially. This age group is usually unable to accurately describe symptoms to parents, so some guesswork and investigation may be required to determine likely causes of mild illness. The only way to check for strep is through lab or rapid tests, so if you notice any symptoms that could be strep, take your child to a doctor, because the disease requires antibiotics and can lead to serious complications without treatment.
The basic symptoms of a sore throat include a fever, which often does not exceed 101°C (38.33°F). Older children may have the highest fever, but the absence of fever is not entirely uncommon in either group. Additional symptoms seen in young children are irritability, a small amount of clear nasal congestion, and upset stomach or refusal to eat. Children who can communicate may complain of a sore throat and sometimes the voice may sound a little hoarse.
Some other signs could include tiredness, although not all children look particularly ill. Occasionally, this age group will also have a small rash between the mouth and nose. Other children may get a rash on the trunk or sometimes the neck. A gentle exam of the lymph nodes in the neck or groin might also reveal a small amount of swelling.
Parents looking down their child’s throat may see enlarged and/or red tonsils. Sometimes, sore throats in children can cause white or yellow patches on the tonsils or back of the throat. Spots on the tongue, however, suggest conditions like thrush.
Some symptoms seem to rule out strep. Extreme nasal congestion, as opposed to a mildly runny nose, a strong cough that produces mucus or diarrhea, could be signs of several diseases, and their appearance could make strep a less likely diagnosis. On the other hand, a slight cough could suggest strep throat. There is a great deal of nuance in determining which symptoms may indicate strep and which symptoms suggest it is not present.
Since a home diagnosis isn’t possible, your best bet if you suspect a child has strep throat to see a child’s doctor. Very active cases of strep are often diagnosed with a rapid strep test that takes only minutes to perform. Sometimes, rapid tests aren’t accurate enough, in which case a throat culture can be obtained and evaluated in a laboratory. Positive cases can usually be confirmed in about 24 hours.
Treatment for strep throat in children is simple: Antibiotics are given to kill the offending bacteria. Depending on the antibiotic, children may need to take medicines for up to two weeks. They must finish all medicines, even if the symptoms are gone, to completely eradicate the infection. If your symptoms return or don’t improve during or after treatment, you may need a different antibiotic.
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