By Dr. Helen Minciotti
One of my more dramatic office visits involved a mother rushing into the office first thing in the morning carrying a vomiting and highly feverish child. Fortunately, in this case the drama did not match the disease. The diagnosis that morning turned out to be the common and generally easy to fix strep throat.
Strep throat or streptococcal pharyngitis is a year-round fixture in the school-age population. Strep is always high on my list of possible diagnoses because it can mimic so many other diseases.
Children with strep typically complain of a sore throat, but the full blown syndrome might also feature severe headache, significant fever, abdominal pain with nausea and vomiting, and a fine pink sandpaper-textured body rash.
Some patients don’t actually have sore throats and this might confuse the picture a bit. These children are brought in with other seemingly unrelated complaints such as vaginal discharge (vaginitis), redness around the rectum (proctitis), or clusters of pimples on the face or other body parts (impetigo).
These signs and symptoms are really not all that unusual, and can occur when the child spreads the strep bacteria from the mouth and nose to other areas of the body. Like sore throats, which are because of strep, most of these minor complications resolve when the child is treated with basic, inexpensive antibiotics.
If a child can’t seem to shake a strep infection or suffers from frequent bouts of strep throat, use of more sophisticated antibiotics or a visit with an otolaryngologist (ENT specialist) might be in order.
Parents can help stop the spread of strep simply by keeping their sick children out of school and other activities until they are fever-free and have been on antibiotics for at least 24 hours. I also like to encourage my patients to change their toothbrushes after two full days of antibiotic therapy (who wants to use a germy old toothbrush, anyway?)
On a final note, some of the ugliest throats I see can’t be blamed on strep bacteria at all. White spots in the back of the throat do not necessarily mean that a child has strep throat and are commonly seen in a wide variety of viral infections. A simple throat swab taken during the office visit helps make the diagnosis of strep.
Viral sore throats do not respond to antibiotics, so don’t be disappointed when your doctor does not prescribe them in these cases. Rest, fluids and, most important, time will help as your children cure themselves of these viral illnesses.
– Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights.
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