Strep throat is a common bacterial infection, primarily affecting children, caused by the bacterium Group A Streptococcus (GAS). This highly contagious illness accounts for a significant portion of sore throats in school-aged children, though most sore throats are caused by viruses. Strep throat requires specific antibiotic treatment, so knowing when to seek a doctor’s evaluation is important for timely diagnosis and to prevent complications. This guidance helps parents differentiate between symptoms that warrant a strep test and those that indicate a less severe viral infection.
Primary Symptoms Requiring Evaluation
Specific symptoms, particularly those with sudden onset, should prompt a visit for a strep test. The hallmark sign is a sore throat that begins abruptly and causes noticeable pain, especially when swallowing. This discomfort is often severe and appears without the gradual buildup typically seen with a common cold.
A fever of 101°F (38.3°C) or higher is another strong indicator, often starting quickly alongside the throat pain. Upon examination, the tonsils and back of the throat may appear red and swollen, sometimes with white patches or streaks of pus. Tiny red spots, known as petechiae, may also be visible on the roof of the mouth, which strongly suggests strep throat.
The lymph nodes in the neck often become tender and swollen due to the body’s immune response. Younger children might also experience gastrointestinal symptoms, such as stomach pain, nausea, or vomiting, instead of complaining about their throat. When these signs cluster together, they require prompt testing to confirm the presence of Group A Streptococcus.
Indicators Suggesting a Viral Cause
Many sore throats are caused by viral infections, such as the common cold or flu, which do not respond to antibiotics. Symptoms pointing toward a viral cause, rather than bacterial strep throat, help parents decide if an office visit is necessary. A sore throat accompanied by classic cold symptoms is often a sign of a viral illness.
Viral indicators include a cough, a runny nose, and a hoarse voice or laryngitis. Diarrhea and conjunctivitis (pink eye) are also frequently associated with a viral infection. When a sore throat presents with these upper respiratory complaints, the likelihood of it being strep throat significantly decreases.
Viral illnesses usually resolve on their own with supportive care, such as rest and hydration, and do not require antibiotics. Observing these symptoms for a few days before seeking a test is appropriate unless the child’s condition worsens. This approach helps avoid unnecessary antibiotic use, which contributes to antibiotic resistance.
Why Untreated Strep Requires Prompt Attention
Treating strep throat quickly is important to prevent serious, delayed complications. Antibiotic therapy must begin within a certain time frame to stop the immune-mediated processes that lead to these secondary conditions. The most concerning complication is acute rheumatic fever (ARF), which can cause permanent damage to the heart valves, joints, brain, and skin.
Another serious complication is post-streptococcal glomerulonephritis, which involves inflammation of the kidneys. Although antibiotic treatment does not always prevent this condition, it remains a risk of an untreated case. Starting the correct antibiotic course within nine days of illness onset is effective at preventing ARF.
If a child tests positive for Group A Streptococcus, a healthcare provider will prescribe antibiotics. This treatment reduces the risk of severe complications, shortens the duration of acute symptoms, and prevents the spread of the bacteria. A child can typically return to school 24 hours after starting antibiotics and once their fever has resolved.