It’s Friday afternoon and the school calls. It’s the nurse. Your 10 year old child is complaining of a sore throat. You rush your kid from school to the pediatrician’s office and the rapid strep test is negative. They diagnose her with a virus. Ugh. Happy weekend.
Let’s chat about what you could have done differently. First. Don’t panic about a sore throat. Yes it could be strep. But it could also be a dry throat, a virus, or seasonal allergies. Or maybe just a crusty piece of bread gone down too fast.
What is the cause of sore throat in kids?
The rapid test was negative, could it still be strep? It’s best to give your child more than a day or two of a sore throat before you rush them into the office. If your child has strep, it may take a day or so for it to fully present itself. A rapid strep test too early may not pick up the strep and you will end up waiting for the culture results anyways. The rapid test needs to have enough strep bacteria to trigger the test positive. The culture takes a few days because the tiny amount of bacteria needs time to grow large enough to be identifiable as strep. You might as well give the sore throat a day or so at home so you get a quick, accurate result. Don’t rush in too fast! Take a few days to rest and monitor symptoms. Over those 2 days, more symptoms may emerge. This can help you to figure out what is going on with your child.
Strep throat in kids
Classic strep throat, or strep throat caused by Group A streptococcus is usually accompanied by fever. The strep toxin can also cause other symptoms such as headaches, belly aches and a rash. Scarlet fever, aka strep rash, can be very subtle. It can be more of a sandpaper like rash that is flesh colored, or it can be more pronounced with red spots all over, or in some patients, appear more hive-like. Not all kids with strep will have this rash. The rash will clear with the antibiotics that you get for your strep treatment. Also, note that a virus can cause a rash too. Talk about confusing! Again, don’t panic! This can be sorted out.
Strep throat can be treated with antibiotics. Lots of fluids will help soothe the throat. Motrin or Tylenol will help with pain and fever. Fever in kids can be rough, so be sure to treat it. Avoid crusty and acidic foods that may cause discomfort to swallow.
Strep likes to hang around and set up shop in your kid’s belongings, like her toothbrush. Get a new one or sterilize your child’s toothbrush 48 hours after starting antibiotics. No kissing or sharing drinks! Strep is nasty. It spreads easily.
Treatment should start to work pretty quickly and your child should feel better in a few days. Make sure to complete your antibiotics so that strep doesn’t come back. Stopping the antibiotics early can cause the “super bacteria” to survive and then come back with a vengeance. So, if you started them, do everyone a favor and finish them!
Non group A strep
What is this? If you get a call that your child’s throat culture grew non group A strep WHAT does that even mean?! Well Non group A strep refers to some bacteria that is commonly found in your throat and other areas of the body. It MAY be a coincidence that your child had a sore throat and then this grew in the culture. Talk to your provider about the plan. Usually treatment is only given for non Group A strep if your child is STILL having symptoms or fevers. If the little babe is all better, and no longer complaining, skip those antibiotics, they aren’t necessary. We often see teens with non group A strep and prolonged symptoms. If this happens to your children, then don’t hesitate to treat them. Teens are whiney enough when they are well!
Viral sore throat in kids
What if your child’s rapid strep test is negative and you are sent home with a diagnosis of a virus? You should take the same care of your child with a sore throat virus as you would a strep infection. Antibiotics won’t help this one. Don’t feel defeated. The time it takes for antibiotics to kick in and treat a strep infection is about the same as it takes a virus to clear on its own. It just SEEMS like strep is a better diagnosis because there is a treatment at the pharmacy. In reality, both treated strep, and a viral sore throat have symptoms that last about the same length of time. A viral sore throat is better, we promise. With a virus, there is no need for antibiotics, which helps with a healthy gut and less risk for antibiotic resistance.
Lots of fluids will help soothe the throat. Motrin or Tylenol will help with pain and fever. As with strep, avoid crusty and acidic foods that may cause discomfort to swallow. Your virus should last about a week. If your symptoms persist more than that, it’s time to get rechecked.
Viral sore throat— hand foot and mouth
A sore throat accompanied by sores in the mouth, on the hands and feet, is usually from something called coxsackie virus, aka Hand, Foot and Mouth. Check out our article on Hand Foot and mouth if your child has sores around his mouth or blisters on her hands or feet.
Dry throat in kids
A sore throat can sometimes be a simple fix. Did you just turn on your heat? Does your child have a stuffy nose? They could be mouth breathing and inhaling dry air all night. The sore throat in the morning will resolve as the day goes on and the throat becomes less irritated. A humidifier can help with this. Cool mist is best! Hot humidifiers are a thing of the past, germy, and a burn risk. If you still have one, toss it out!
Using nasal saline to help loosen up nasal congestion can open things up and allow your child to breathe through their nose instead of the mouth. A warm bath and a good nose blow helps too. If they are too young to blow their nose, the nosefrida is AMAZING. Get one! It sounds grosser than it actually is!
Seasonal allergies in babies, toddlers, and older kids
Seasonal allergies can cause a sore throat in kids (adults too, obvi). They can make you miserable, itchy, and a drippy, runny mess. Babies and toddlers can get seasonal allergies too. If it’s springtime and the trees are blooming, or the fall ragweed is blowing in the breeze, think about seasonal allergies as the culprit for your symptoms. Nasal saline is going to be a good friend. Clear up that mucous that is dripping down the back of your child’s throat with some saline. You want it to spray up and then wash back down the back of the throat. This will break up the stream of mucous and help make that sore throat feel better. Now grab a blanket, it’s time to wrap that kiddo up like a burrito and squirt that saline. We promise, it’s worth it! Don’t try and spray saline with a flailing child, it won’t work! Grab a helper or a giant bath towel.
You can also talk to your pediatrician or urgent care provider about over-the-counter allergy meds like claritin or Zyrtec as well as Flonase nasal spray. These medications can help alleviate your symptoms as well. If your child has a fever, it’s likely not seasonal allergies, these won’t cause fever.
When your child should be seen by a provider for sore throat
In general, for any fevers that last more than 4 days, symptoms that are prolonged more than 5-7 days, or worsening symptoms, you should always be seen. Call right away and be seen immediately with difficulty swallowing, drooling, difficulty breathing, barking croup-like cough, or if your child is ill appearing. If you aren’t sure, chat with us at Nurse-1-1 and our nurses can help sort out your child’s symptoms. You are not alone. We can help!
Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like, I have been suffering from headache and fatigue for a while. Should I be worried? Why is my child’s poop yellow? Is fever in kids bad? Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.