Streptococcus in Children: Symptoms, Dangers, and Effective Treatment

Streptococcus in children is a very common "infection, a problem that often occurs especially when they attend kindergartens, schools, sports centers, etc. It is a bacterium that can belong to different strains, lurk in various areas of the body and cause symptoms. different according to the case. Let's see what to do and how to intervene without panic. Before continuing, however, we want to suggest a useful video with some hygiene rules for the little ones.

What is strep in children?

Do not immediately think about strep throat every time the child has a sore throat and fever, in fact in most cases the causes can be other. It is useful to know that streptococci are a group of bacteria characterized by a spherical shape. There are various types, and while some are harmless to humans, others can cause various diseases such as pharyngitis and tonsillitis, ear infections, pneumonia, meningitis, generalized infections (sepsis).

Among these, the Streptococcus Pyogenes, or beta-hemolytic streptococcus group A, is the main bacterium that causes pharyngitis and pharyngotonsillitis. After this overview it is good to specify that in most cases pharyngitis has a viral origin and only in 20-30% of cases can it be caused by the streptococcal bacterium. Streptococcal pharyngitis is more common in school-age children and adolescents between the ages of 5 and 15. In most cases, it never occurs before the child is 3 years old.

See also

Mononucleosis in children: symptoms and treatment of this infectious disease

Otitis in children: symptoms and treatment of earache in case of infection

Streptococcus in pregnancy: why the test must be done even without symptoms

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The most frequent symptoms of strep in children

The discussion on streptococcal symptoms is rather complex, especially since so many factors must be considered. Streptococcal pharyngotonsillitis is characterized by sudden and severe sore throat, high fever (above 38 ° C), redness of the pharynx and tonsils, presence of small red dots on the soft palate and small plaques on the tonsils, swelling of the glands of the neck, placed under the mandibles. Other symptoms can be:

  • headache,
  • stomach pain,
  • nausea or vomiting, especially in children.

It must be considered that plaques can also be present in tonsillitis of viral origin, as in the case of adenovirus or mononucleosis infections, so the mere fact of seeing them cannot be enough to make a diagnosis of streptococcal infection.

If, on the other hand, the fever in the child tends to be low and other symptoms such as cold, conjunctivitis, hoarseness or diarrhea are also present, it is extremely likely that the sore throat is caused by viruses and not bacteria.

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Streptococcus in children: how to make the diagnosis

Diagnosing streptococcus in children is not easy, even experienced and specialized doctors often resort to swabs to remove any doubts. Clinical observation is often not enough and only the throat swab can eliminate any doubts. Since the symptoms can be similar to those caused by other viruses or bacteria, no doctor, no matter how good, will be able to make a diagnosis of streptococcal infection. based only on the symptoms he observes.

Clinical observation is in any case important and helps the doctor to understand in which cases it is appropriate to take the swab, in fact it is not necessarily absolutely necessary. less strep infection in children.

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When is throat swab useful and how to do it?

Let's start by specifying that the swab to test for streptococcal infection in children should not be done in asymptomatic subjects, that is, all those who do not have a sore throat and fever. It is estimated that about 30% of children are asymptomatic carriers of the bacterium. so there are children who have strep, and they would test positive, but they don't have to be treated with antibiotics because they don't have an "active infection."

Doing a swab to all children, without precise clinical indications, means finding oneself with a whole series of positive results that do not have a truly important meaning from a clinical point of view. Among other things, in children positive to the swab but asymptomatic, the antibiotic does not allow anyway to eradicate the bacterium present.

But how is the tampon made? Is it invasive for the child? The sample is carried out by vigorously rubbing a large cotton swab on the oropharynx and on the surface of both tonsils, avoiding touching other parts of the oral cavity or contaminating it with saliva.

Many pediatricians have a quick test in the outpatient clinic that allows immediate analysis of the swab, and after only 5 minutes the result will be obtained: streptococcus yes or streptococcus no. In other cases the pediatrician may decide to send the swab the swab for a " deeper but slower analysis: in this case it will take at least 48-72 hours to get the result.

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How to cure strep in children?

If the throat swab confirms the presence of strep and the child presents with fever and cough, then it will be time to resort to the right antibiotic therapy. The active ingredient usually prescribed by the pediatrician is amoxicillin, to be taken for 10 days while remaining under close medical observation.
Why the antibiotic?

  • helps to heal faster (although the course would still be rapid),
  • prevents the spread of the disease
  • but above all it prevents complications such as rheumatic fever.

The pediatrician or doctor may decide to combine the antibiotic with other pain relieving and / or antipyretic medicines (for fever), such as:

  • paracetamol (Tachipirina),
  • ibuprofen,

able to relieve local (sore throat) and systemic symptoms (such as fever and widespread malaise).

Pay attention: whatever therapy is prescribed, it must be completed even if the symptoms improve after the first two or three days. This is because only with 10 days of therapy it is really possible to eradicate the streptococcal bacterium. In the event that pharyngitis is caused by a viral infection, no specific therapies are required because it heals on its own.

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Streptococcus in children: risks and complications

In the vast majority of cases, strep throat has a benign course, even if it is not treated. If, on the contrary, it is neglected without therapy and adequate care, in a minority of cases it can become complicated in acute forms that include:

  • tonsillar or retromandibular abscesses
  • formation of pus
  • high fever.

They are much rarer, but complications due to immune-type mechanisms can also occur, including:

  • rheumatic disease, characterized by fever and joint pain and can cause serious consequences, such as heart valve failure; luckily today it is quite rare, but it was not the same about 50 years ago.
  • San Vito's dance (Sydenham's chorus), neurological disease characterized by involuntary and uncoordinated movements of the limbs and face, sometimes associated with behavioral alterations and the onset of anxiety.
  • glomerulonephritis, an inflammatory disease of the kidneys, which can permanently compromise its function.

Although rare, the complications described above are very serious, so it is good to never neglect streptococcal infections in children, contacting the pediatrician immediately to start antibiotic treatment.

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Frequently asked questions about strep in children

The child always has a fever and it never passes, can it be strep?
If you see that the child is inappetent, tired and lacking in vivacity, if he has persistent fever and sore throat, it is much more likely that it is a viral infection and therefore that the streptococcus does not enter anything. see your pediatrician for a thorough examination on infections.

How does the infection happen and when can you go back to school?
Streptococcal infection occurs via the respiratory tract. Defending yourself from streptococcal infection is difficult especially if some schoolmate has caught it, it is likely that coughing or sneezing can infect others. If, on the other hand, your child is sick, it is best to avoid school for a few days. When he has recovered and started antibiotic therapy, however, he will be able to return to school.

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Can strep in children be prevented?
Streptococcus can be contracted several times, so the fact that you have already had the infection once does not protect you from the risk of getting it again. There are no vaccines to prevent, but you can take some useful precautions.
If you know you have streptococcal infection, you will have to stay at home and avoid going to work, school or kindergarten, until the fever is gone and you have started antibiotic therapy for at least 24 hours.

Here are the good habits to avoid getting or spreading strep:

  • cover your nose and mouth with your elbow when sneezing or coughing, it would be better to use a mask;
  • throw away used handkerchiefs immediately after use;
  • wash your hands often with soap and water for at least 20 seconds;
  • use an alcoholic hand sanitizer in the absence of soap and water;


How often can the child have strep?
However, streptococcal infection does not leave permanent immunity: it is possible to get sick more than once. More problematic is the treatment of infections of the Streptococcus pneumoniae which has become resistant to antibiotics.

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