Streptococcal Infections

Parenting in the Early Years

Streptococcal Infections

Many infections are caused by bacteria called Streptococci. The most well known are the infections caused by Group A strains, which include strep throat and a skin infection called impetigo. Not uncommonly, infants and toddlers can have strep infections in the nose, anus or vagina.

Strep throat is usually accompanied by throat pain, high fever, headaches and swollen neck glands. The throat becomes inflamed and there are often white spots on the tonsils, red spots on the soft palate and the tongue may become rough and bumpy. Stomachaches and vomiting are common. If a red, sandpaper type rash develops with strep throat it is then called Scarlatina or Scarlet Fever.

Unfortunately, strep infections can have some severe consequences. One complication of strep infection is Rheumatic Fever. This causes heart damage, arthritis and possible damage to the nervous system. Strep infections can also cause a kidney disease called glomerulonephritis.

There is a very aggressive type of strep that has been associated with pneumonia and blood infection, causing death in a short amount of time. Fortunately, this strain of strep is rare.

The diagnosis of strep throat is suspected by a history and physical exam. The diagnosis is confirmed by obtaining a swab of the throat and if indicated a rapid strep test is done. If the rapid test is negative a throat culture is done that takes one or two days for an answer.

Strep infections are treated with antibiotics, penicillin being the most frequently prescribed. If your child is allergic to penicillin another antibiotic will be prescribed. Response to treatment is quite fast and definite improvement should occur within 48 hours. Occasionally a strep infection will not respond to treatment and another antibiotic will be needed. If your child does not improve, contact your doctor. It is very important to take the full ten days of the medication as prescribed.

An infected child is contagious until he has been on medicine for 24 hours. It takes 5 to 14 days for the strep to grow in someone who has been exposed. If you culture the exposed person during that incubation stage you can recover the strep germ. Sometimes several members of a household become infected with strep and will need to be seen by their physician.

If a child develops recurrent strep infections, other household members will need to be checked to see if they are the source of strep.

Tonsillectomy may be indicated if your child has five documented strep throat infections in a year or three infections per year for two or more consecutive years.

Attempts should be made to keep your child comfortable and well hydrated. Ice cream and popsicles frequently provide temporary relief from throat pain while providing fluids. Acetaminophen or ibuprofen give fever and pain relief and are safe to give along with antibiotics.