Q: My 16-year-old daughter is always getting strep throat. Her symptoms are only a slight scratchy throat and never a fever. I am told it can be harmful to her organs if she continues to carry it and it's not treated right away. What are my options and should I be concerned? - P.C., Fort Lauderdale
A: Poor kid! First, make sure to go to your pediatrician's office for sore throats, if possible. This allows your doctor to really count the times per year that your child gets strep throat. Unfortunately, sometimes you have to go to an emergency department or urgent care center that is not affiliated with your pediatrician because you are out of town or your doctor's office is closed. Make sure to call your pediatrician's office to let them know about the strep throat anyway. Your child's pediatrician should be their medical home, and their chart should reflect all urgent care and ED visits - not just their standard physicals and home office sick visits.
Strep throat is caused by a bacteria called Streptococcus pyogenes. In order to determine whether a sore throat is strep throat or a viral infection, a test must be done. A throat swab for a five-minute rapid test will be performed and, if positive, antibiotics will be prescribed. If the rapid test is negative, the second swab will be used for a throat culture that requires a few days for results. Do not take antibiotics if no test is done.
On the other hand, if the test is positive for strep, take all the antibiotics as instructed. By only taking some of the antibiotics, symptoms are improved for a time but the infection is not cured. This also increases the risk of the more dangerous effects of strep like scarlet fever, rheumatic heart disease and kidney inflammation.
In addition, your pediatrician may want to check for a carrier state, though it is very difficult to truly determine carrier state. Since antibiotics during an acute infection virtually eliminate the most dangerous effects of strep, positive strep tests, whether acute or suspected carrier, will most likely be treated with antibiotics.
Your concern level really depends on how often your child is getting strep throat. Your pediatrician will help you decide if she may need more than antibiotics, based on how many times a year she gets strep throat and how many years in a row this occurs. If strep is occurring too often, a referral to an ear, nose and throat specialist may be needed.
Have a question for Dr. Blythe? Write to her at AskThePediatrician@tribune.com
Dr. Diana Blythe, MD, is a board-certified pediatrician with Pediatric Associates in Plantation. A South Florida native, Dr. Blythe was raised in Coral Gables. When she isn't seeing patients, Dr. Blythe enjoys diving, spearfishing and cheering on the Miami Dolphins.