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How do you diagnose strep throat?��

“Mainly, we look for significant redness in the back of the throat, little red dots on the��roof of the mouth (called petechiae) and white spots (called exudates) on the tonsils,”��Dr. Sakhno says. “Sometimes, we see a rough rash on the child’s skin that feels like sandpaper and a bumpy red tongue that resembles the skin of a strawberry; these are signs of scarlet fever.��

“Strep throat is highly contagious,” she adds. “Therefore, we ask parents and caregivers whether anyone else in the family or any of the child’s classmates has a strep infection.”��

This is especially important in children who have recurrent strep infections to help��identify the source.��

Thankfully, there are tests your pediatrician can perform in the office to confirm or rule��out strep throat. “A quick test that has been available for many years is the rapid��antigen test. However, it can miss up to 30 percent of cases. That’s why a follow-up��throat culture can be needed, but it can take several days for the results to come back. Fortunately, a test called the rapid strep PCR assay is 95 percent accurate and only takes 20 minutes. This PCR (polymerase chain reaction) test is what our Cornell pediatric clinics use,” says Dr. Sakhno.��

Are there other possible diagnoses?��

Depending on your child’s vaccine history, your pediatrician may be able to rule out two��rare, potentially life-threatening conditions that also cause a sore throat: e�辱�����dzٳپ��پ���—a����infection of the small flap that covers the windpipe, caused by Haemophilus influenzae����type b (Hib); and Diphtheria, another deadly bacterial disease that obstructs breathing��and swallowing.��

Both of these have become quite rare in the U.S., thanks to safe and effective vaccines.��The Hib vaccine, administered to infants as young as 2 months old, protects against��epiglottitis caused by the Hib bacteria. And since the introduction of the DTaP vaccine (the��“D” in DTaP stands for Diphtheria), that deadly disease has all but disappeared in the��U.S.��

A slew of viral infections can cause a sore throat. But, as Dr. Sakhno notes above,��these are often accompanied by a runny nose, congestion and cough, meaning it’s��unlikely that the child has strep when these symptoms are part of the mix.��

How do you treat strep throat?��

Penicillin or amoxicillin taken for 10 days are both highly effective. And, fortunately, if��your child is allergic to these antibiotics, alternative options are available.��

Why is it necessary to take antibiotics for strep throat?��

Beyond the curative powers of antibiotics for strep, it’s critically important for your child��to take them to prevent both immediate complications and delayed post-strep sequelae (consequences) that can occur weeks after a strep infection. These include the following:��

Supportive measures, such as warm liquids, lozenges, acetaminophen and ibuprofen,��can help your child feel better. But, Dr. Sakhno advises, “avoid viewing these as��alternative treatments capable of fighting the strep infection on their own.”��

When is a tonsillectomy recommended?��

Tonsillectomy isn’t usually indicated, even for recurrent infections, because children��typically outgrow them as they mature. But “there may be times when an ENT consult is��recommended,” she says.��

When can my child return to school after a strep throat episode?��

According to the most recent studies, 91 percent of children test negative 12 hours��after starting antibiotics for strep throat.����Therefore, it is a-okay to��have your child return to school when �ٳ���’v�� been on antibiotics for at least 12��hours and has been fever-free for at least 24 hours without using fever-reducing��medications such as acetaminophen or ibuprofen.��

If you or your child has symptoms of strep throat, make an appointment with a provider at �ձ�avɫ��Ƭ.