The terms sore throat, strep throat, and tonsillitis often are used interchangeably, but they don’t mean the same thing. Tonsillitis refers to tonsils that are inflamed. Strep throat is an infection caused by a specific type of bacteria, Streptococcus. When your child has a strep throat, the tonsils are usually very inflamed, and the inflammation may affect the surrounding part of the throat as well. Other causes of sore throats are viruses and may only cause inflammation of the throat around the tonsils and not the tonsils themselves.
In infants, toddlers, and pre-schoolers, the most frequent cause of sore throats is a viral infection. No specific medicine is required when a virus is responsible, and the child should get better over a seven to ten day period. Often children who have sore throats due to viruses also have a cold at the same time. They may develop a mild fever, too, but generally aren’t very sick.
Strep throat is caused by a bacterium called Streptococcus pyogenes. To some extent, the symptoms of strep throat depend on the child’s age. Infants with strep infections may have only a low fever and a thickened or bloody nasal discharge. Toddlers (ages one to three) also may have a thickened or bloody nasal discharge with a fever. Such children are usually quite cranky, have no appetite, and often have swollen glands in the neck. Sometimes toddlers will complain of tummy pain instead of a sore throat. Children over three years of age with strep are often more ill; they may have an extremely painful throat; fever over 102 degrees Fahrenheit (38.9 degrees Celsius), swollen glands in the neck, and pus on the tonsils. It’s important to be able to distinguish a strep throat from a viral sore throat, because strep infections are treated with antibiotics.
Diagnosis and Treatment
If your child has a sore throat that persists (not one that goes away after her first drink in the morning), whether or not it is accompanied by fever, headache, stomachache, or extreme fatigue, you should call your pediatrician. That call should be made even more urgently if your child seems extremely ill, or if she has difficulty breathing or extreme trouble swallowing (causing her to drool).
This may indicate a more serious infection. The doctor will examine your child and may perform a throat culture to determine the nature of the infection. To do this, he will touch the back of the throat and tonsils with a cotton-tipped applicator and then smear the tip onto a special culture dish that allows strep bacteria to grow if they are present. The culture dish usually is examined twenty-four hours later for the presence of the bacteria.
Most pediatric offices perform rapid strep tests that provide findings in minutes. If the rapid strep test is negative, your doctor may confirm the result with a culture. A negative test means that the infection is presumed to be due to a virus. In that case, antibiotics (which are antibacterial) will not help and need not be prescribed.
Source: American Academy of Pediatrics.