The Sore Throat Dilemma

Is it Strep, is it allergies or is it just a sore throat? How many times do we pediatricians hear this complaint? Even for us in the medical field it is not an exact science to diagnose a strep throat. Many factors are taken into account when a sick child presents with a sore throat. Here are some pointers to keep in mind.

• If your child has other symptoms such as a “pink eye,” a cough, runny nose AND a sore throat, this is probably not a Strep throat. Strep throat comes with a particularly harsh sore throat, difficulty swallowing and many times, although not always, a fever. A cough and a runny nose are not part of the typical Strep throat illness.

• The incubation period of a streptococcal infection is 2 to 5 days. So if the sibling or classmate had strep throat two weeks ago, you child did not get it from them.

• At your doctor’s office, a quick strep test can be performed but is not always 100% accurate. If positive, yes, the sore throat is more likely to be a strep infection. But a negative quick strep test doesn’t rule out strep throat, hence we send the throat swab for an overnight culture to the laboratory.

• Some children carry the bacteria in their tonsils all the time, hence called “carriers.” The test may be still be positive but if the child doesn’t have symptoms there is no need to treat with antibiotics.

• Amoxicillin is still the drug of choice for a Strep throat. If you have allergies to the penicillins (which includes amoxicillin) let your health provider know and an alternate medication will be prescribed.

• Last but not least, many upper respiratory infections (URI) present with a runny nose, watery eyes, sore throat and a cough. A fever may also be part of the illness. Most of these are viruses and do resolve on their own anywhere between 7 to 10 days. For these situations, encourage lots of fluids, humidifiers, good nose blowing (or suctioning) and a large dose of TLC. Of course, we can’t stress enough the good hand-washing, avoid sharing eating utensils and changing tooth brush after 2 to 3 days of treatment.

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Founder of Healthy Chats, Dr. Chrystal de Freitas is a pediatrician, author and mother of three children who has a special interest in health education. She completed her pediatric training at the University of Washington, in Seattle, WA, and has been in private practice for 22 years. She practiced with North County Health Services in Encinitas, for 6 years. In 2004, Dr. de Freitas opened her solo private practice of pediatrics, Carmel Valley Pediatrics in San Diego, CA.