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Bacterial Infections in Childhood: Strep Throat


Strep throat is a throat infection caused by the group A -hemolytic streptococcus bacteria . Strep throat infections are contagious and strep bacteria commonly pass from person to person in the fluid droplets of coughs and sneezes. Streptococcus bacteria can also contaminate food, water and milk. In some cases, a strep throat infection can lead to scarlet fever, or be followed by rheumatic fever or glomerulonephritis (a kidney problem). Strep throat is the most common type of throat infection caused by bacteria, and it tends to affect children between 5 and 15 years old. Despite being the most common type of throat infection caused by bacteria, strep throat only causes about 15% of all cases of sore throats with the vast majority caused by viruses .

Symptoms and Signs

A child who has strep throat will have a sore throat, will often vomit and complain of headache or abdominal pain for several hours before the throat pain begins. Fever may also be present and can reach 40°C (104 F). The child may have difficulty swallowing and may develop painful swollen glands on the side and in the front of the neck. About two out of three children have only a mild redness inside their throats, but the rest have large, red tonsils. There may also be white craters or specks of pus on the tonsils, or the tonsils may be covered with a grey or white coating, but this is present in only about 50% of all cases. Sometimes, on the child's soft palate (towards the back of the roof of her mouth), there are tiny red spots or speckles.

Diagnosis and Treatment

Since bacteria can be treated with antibiotics while viruses can not, diagnosis will focus on determining if the sore throat is indeed strep throat and thus can be treated with antibiotics. Swabs of fluids from the back of the throat are usually taken and often an instant strep test can be done on the spot. Otherwise the swab of fluids is sent to be analysed for the presence of bacteria.

Strep throat infections are treated with antibiotics, most usually penicillin or, in the event of penicillin allergy (cf. HON Allergy Glossary ), erythromycin, taken by mouth for 10 days. Antibiotics typically bring down the child's fever within 24 hours, and probably shorten the whole illness by a day or two. Up to 20% of children may exhibit persistence of the streptococci after treatment with oral penicillin. If streptococci persist following a second course of therapy, it indicates a probable carrier state. It is probably unnecessary to retreat asymptomatic children with persistent positive throat cultures.

The information in this page is presented in summarised form and has been taken from the following source(s):
1., Children's Health Section:

Other HON resources 
   From MedHunt

Strep Throat
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Contact Last modified: Jun 24 2002