Q: Why do doctors avoid strep tests in children under age 3?
We generally don’t recommend doing throat swabs to diagnose acute group A streptococcal pharyngitis for children under the age of 3 years, except in certain circumstances such as:
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- An outbreak in a daycare center.
- Close contact with a strep-positive patient.
- Clinical findings consistent with strep pharyngitis by the treating provider.
We treat strep to decrease the duration of the disease’s acute symptoms; and prevent complications, such as sinus infection, ear infection, and abscesses in the throat area. However, the most important reason we treat it is to prevent acute rheumatic fever and acute glomerulonephritis, a serious kidney problem.
With that said, and knowing that the risk of acute rheumatic fever is very rare in children under the age of 3, we rarely recommend looking for strep pharyngitis for this age group.
If you do suspect strep in a very young child, talk to your child’s primary care provider immediately. Very young children have different symptoms than older children when it comes to acute strep pharyngitis. They show signs that include but are not limited to runny nose, decrease appetite, fever, and fussiness, as well as history of exposure.
— Pediatrician Wadie Shabab, MD., F.A.A.P.