Untreated strep throat in children can sometimes lead to problems such as abscesses near the tonsils, scarlet fever, kidney inflammation, or, rarely, rheumatic fever. The good news is that prompt testing and the right treatment greatly lower the risk, so if your child has symptoms of strep, it is best to have them checked.
Most children recover quickly once strep throat is diagnosed and treated. Because many sore throats are caused by viruses instead of strep bacteria, a throat swab is the best way to know whether antibiotics are needed.
What Is Strep Throat?
Strep throat is a throat infection caused by Group A Streptococcus bacteria. It is most common in school-aged children, though younger children and teens can get it too.
Strep can look different from a typical viral sore throat. Children with a virus often have cough, runny nose, hoarseness, or mouth sores, while strep throat more often causes sudden throat pain, fever, painful swallowing, swollen glands, and red or swollen tonsils. Since symptoms can overlap, testing is important before starting antibiotics.
Common Strep Symptoms in Kids
Some children clearly complain of a sore throat, while others mainly have fever, headache, stomach pain, or seem unusually tired. Younger children may not be able to describe throat pain well.
- Sudden sore throat
- Pain with swallowing
- Fever
- Red or swollen tonsils
- White patches on the tonsils
- Swollen, tender lymph nodes in the neck
- Headache
- Stomachache, nausea, or vomiting
- Fine red rash that feels like sandpaper
Symptoms like cough, runny nose, hoarse voice, and pink eye are more often linked to a viral illness than strep. If you are not sure what is causing your child’s sore throat, our pediatric team can examine your child and decide whether strep testing is needed.
What Can Go Wrong With Untreated Strep Throat?
Most children with strep throat do well, especially when they are treated early. Still, untreated strep can sometimes lead to complications, either from the infection spreading nearby or from the body’s immune response after the infection.
Complications From the Infection Spreading
- Peritonsillar abscess: A pocket of infection can form next to a tonsil, causing severe throat pain, muffled voice, drooling, or trouble swallowing.
- Retropharyngeal infection: A deeper infection behind the throat can cause neck pain, trouble swallowing, or breathing problems and needs urgent medical care.
- Swollen infected lymph nodes: Neck glands may become very tender, enlarged, warm, or red.
- Ear or sinus infections: These are common childhood infections and may happen around the same time as strep symptoms.
Complications That Can Happen After Strep
- Scarlet fever: This is strep throat with a red, rough rash and fever.
- Rheumatic fever: This rare complication can affect the heart, joints, skin, and nervous system. Treating strep helps prevent it.
- Post-streptococcal glomerulonephritis: This is a type of kidney inflammation that may cause dark urine, swelling, or less urination.
You may also hear about sudden behavior changes or tics after a strep infection. If your child has abrupt neurologic or behavioral symptoms, they should be evaluated promptly so the cause can be assessed carefully.
When to Call the Pediatrician Right Away
Call your child’s pediatrician if they have symptoms that could be strep, especially fever with sore throat and no cough. Seek urgent care right away if your child has:
- Trouble breathing
- Drooling or trouble swallowing
- Severe one-sided throat pain
- A muffled or “hot potato” voice
- Neck swelling or stiffness
- Signs of dehydration, such as very little urine or inability to drink
- Symptoms that are getting worse instead of better
If your child needs an evaluation, Omega Pediatrics can help with sick visits, testing, and guidance on the next steps.
Same-day and next-day appointments available.
How Strep Throat Is Diagnosed
Strep throat cannot be diagnosed by symptoms alone. A visit usually includes an exam and a throat swab for a rapid strep test. If the rapid test is negative but strep is still strongly suspected, a throat culture may be sent, especially in children.
It is best not to use leftover antibiotics or medication prescribed for someone else. Children should only take antibiotics when strep is confirmed or when the Omega Pediatrics team determines treatment is appropriate.
How Strep Throat Is Treated
When testing confirms strep throat, antibiotics are used to treat the infection. Treatment helps your child become less contagious, may shorten symptoms somewhat, and lowers the risk of complications like rheumatic fever.
- Give the medicine exactly as prescribed.
- Finish the full course, even if your child feels better sooner.
- Keep your child home from school or daycare until they have been on antibiotics for at least 24 hours and are feeling well enough to return.
- Encourage fluids, rest, and soft foods.
- Use age-appropriate pain or fever medicine if recommended by your child’s clinician.
If your child is not improving after 48 hours of antibiotics, cannot keep medicine down, develops a rash, or seems worse, contact our pediatric team for advice.
How to Help Your Child Feel Better at Home
Along with prescribed treatment, simple home care can make your child more comfortable while their throat heals.
- Offer water, ice pops, warm broth, or other soothing fluids.
- Choose soft foods like yogurt, applesauce, soup, or mashed potatoes.
- Use a cool-mist humidifier if the air is dry.
- For older children, warm salt-water gargles may help.
- Make sure your child gets plenty of rest.
Avoid sharing cups, utensils, water bottles, or towels while your child is sick.
Can Strep Throat Be Prevented?
You cannot prevent every case of strep, but good hygiene helps reduce spread at home and school.
- Wash hands often with soap and water.
- Teach children to cover coughs and sneezes.
- Do not share drinks, utensils, or food.
- Clean commonly touched surfaces when someone in the home is sick.
- Replace a toothbrush after your child has been on antibiotics for a day or two if your clinician recommends it.
When in Doubt, Get Your Child Checked
Most sore throats are not dangerous, but strep throat is worth checking because the right diagnosis guides the right treatment. Early testing can help your child feel better sooner and lower the chance of complications.
If your child has a sore throat with fever, swollen glands, or painful swallowing, schedule a sick visit with Omega Pediatrics. The Omega Pediatrics team can evaluate symptoms, perform testing when needed, and help your family know exactly what to do next.
