F/U To My Possible Strep Q-

Updated on May 07, 2013
F.B. asks from Kew Gardens, NY
12 answers

Mamas & Papas-

Let me preface this question by saying, that I am a first time mom, and that I was a very sickly child, and I seem to recall nearly always being on AB as a child either for an ear infection, throat infection, or something else. Neither hubs nor I are quick to accept prescriptions or use medicine, heck we even eschew AB soap and lotions; but it seems that everytime we take DS to the MD, we walk out with a script. That said-

Isn't a doctor able to tell the difference between something which is viral and something which is bacterial, and prescribe accordingly?

Are we taking him to the doctor too soon? Should we wait a few days with a fever, cough, sneezing, sore throat, and see if he improves on his own?

Should we give him children's tylenol to bring down a fever ASAP, or "let the fever do its work" and just give him comfort care for
the first day or so.

Should we gauge our response based on our kid's behavior? Most of the time, he's go go go x10, if he's got a cold he's still more
active than the average child, yesterday's episode had him acting like a sick and compromised kid for the first time ever.

Thanks for your advice.
F. B.

PS- DS is in daycare, we work full time. Daycare will allow him back with a lingering cold or runny nose, but won't have him there with a fever. (fair enough)

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C.O.

answers from Washington DC on

B.!

I swear!! Every time I see "F/U" I think of someone telling people to F**K off!! LOL!!!

No, it's not always easy to tell the difference between a virus and a bacterial infection. That's why they do the swabs.

For fevers - I try the Tylenol or Advil and then a shower until the water is cold (my kids are older now - so when they were younger - it was a bath until the water was cold) to draw the fever out. It's an old-wives tale, but has worked for me over the years.

If your son was acting TOTALLY unlike himself - you did what you felt was right for the situation...took him to Urgent Care...that is what worked for you.

I don't get how any medical facility in the U.S. can't get you a strep swab answer in 5 minutes. That's my confusion. I try NOT to give antibiotics. But that's ME.

You did what's right for you and your child. Heck if my kids were lethargic and not acting normal with a fever - and a fever of 101 is HIGH for them - I most likely would have done what you did!!

It appears you might be taking this too personally. It doesn't matter what i or anyone else would do. This is YOUR child. You did what was right for you and your family....

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K.P.

answers from Miami on

I don't believe that most doctors can easily differentiate between viral and bacterial (hence the tests). However, most doctors (at least ours) will tell you that most healthy children can fight either type of infection, if given time and rest. Our pediatrician has suggested that we wait a good 24 hours before bringing the kids in, unless there is something really "off". After 24 hours if the fever is still present, we take them in.

I don't give Tylenol right away b/c then my child feels better and overdoes it. That's my choice and our doctor supports it. I give the Tylenol at night so that they can fall asleep. Having said that, if one of them spiked a really high fever, I would probably give it immediately. Fortunately we have not been in that situation.

We have two children and can honestly say that we took the older one in far more often than the little one. He had a lot of ear infections and we could usually tell when one was coming. 90% of the time, we were right... about 50% of the time we had him on AB. I was able (at that time) to flex my hours, so we would just keep him home and let him get better.

I don't think you can really be too cautious when it comes to your child's health. Don't get nuts about it, but it never hurts to call, especially if his behavior is REALLY off.

If you guys decide to have a second one... TOTALLY different. Our little one is more rugged than her older brother and it's because we let her get sick once in a while, scrape her knees and fall down far more often then we did for her big brother!

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V.K.

answers from Minneapolis on

Oh my god, I also thought 'F/U' was 'F*ck You'. I was sitting there thinking 'WHOA! What did I miss?!' Lol

If kiddo is acting normal... I just keep his temp down and don't worry too much about it. If he is acting out of the ordinary, THAT is when I start to worry.

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L.R.

answers from Washington DC on

Getting the swabs done to know for sure whether it's viral or bacterial is key, I think. You really do want to rule out strep, or treat it appropriately if it is strep, because untreated strep can turn into scarlet fever. Even if it doesn't progress to that stage, untreated strep can turn pretty nasty for the patient.

I would never gauge whether to have a child seen by the doctor based just on the child's behavior because, as you note yourself, some kids (like yours) are still pretty active when sick. And some have high tolerance for pain, which can mask things. My child had appendicitis with no fever or severe pain until one hour before they yanked her appendix out -- fortunately, we took her to our doctor early on, a full day before they removed her appendix, when her only symptoms were one vomit and a stomach ache (not screaming pain), and the doctor said, "I want her taken to the hospital just to be sure, because she has a high tolerance for pain and might not exhibit a lot of pain if it turns out it IS appendicitis." And it was indeed that -- the doctor was absolutely spot on.

I've also known kids, my own and others, who were walking around acting just dandy yet had strep when tested.

One other thing. Get the "lab" test and NOT just the strep "quick test." The quick test seems to me to give more false negatives, or it just doesn't pick up strep early enough, and then a few days later you may be back at the doctor's office with a sicker kid. My child has gotten the all-clear from a quick test (done then and there in the office) and two days later turned up positive according to a lab test (sent to a medical lab and cultured).

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M.C.

answers from Washington DC on

We both work, so I completely understand the daycare issue. Our daycare and school rule is 24 hr fever free with no medicines (tylenol/motrin/etc).

For a fever, if the fever is under 100, I usually let it ride, unless my kid complains. Then I give Tylenol. If the fever is 101 or higher, I give Motrin because it works better on high fevers.

If the fever gets to 103+, give Mortin ASAP and cool him down with a wet cloth.

The doctor can tell if something is bacterial by doing a swab culture. If it is bacterial they should be able to see it under the microscope. Sometimes looking in to your ear at an infection, depending on how it looks, they can tell if it is bacterial or viral. Bacterial infections can usually be treated with meds. Viral infections, usually can't.

For my kids, when they tend to get a lot of ear infections, it has ended up being related to a food allergy. When they go through a series of strep, it's usually because they've had a bad cold that wouldn't clear up.

When your kid is acting completely opposite of normal, than take them to the doctor.

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L.M.

answers from Dover on

I think you have to evaluate on a case by case basis.

My daughter stayed home once not feeling well and feverish and was fine the next day. No doctor visit, no meds, just lots of liquids and TLC. She's had strep a few times and is typically feeling great in 24-48 hours (usually 24 hours) after starting antibotic. Just two weeks ago, she came home with a fever that came down right after nurse gave her Motrin. Thought she could go back the next day until the fever spiked. Next day she tested positive for strep and started an antibotic and was told she could go back on Friday. Well Friday she had 103 fever AGAIN. On Saturday, fever still there and she was very lethargic. Another doctor visit, blood work, and change in antibotic and she was better on Monday but not really well until Tuesday. It seemed that she had strep but possibly a cross infection with something else too.

It's not always cut and dry so neighter is our response.

I will say that when in doubt, err on the side of caution and go w/ your gut.

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M.S.

answers from Portland on

If my kiddo, who goes like it sounds yours does, acted sick and lethargic, I would go to the doctor too! I think you did the right thing actually, and usually my doc won't give antibiotics. My son has been on them once for bronchitis, and my daughter who is 3.5 has never been on them so as you can see, he really doesn't give them out much at all. If I am worried or concerned, I call the advice nurse and she will usually tell me what I should do, bring them in, wait and see, etc.

The other thing I make sure to do is to take their temperatures when they are not sick. I do this randomly until I have a good sense of what normal is for them. This is because each person is different, and 98.6 is an average. I run at 96.8, my son runs at 96.4, my daughter runs at 98.0. I haven't figured out my husband's yet, as I figured he could do himself. But, that being said, no, I don't wait until 101 to give Advil, but that is way way too high! If its 100 or more I start fighting the fever with meds and cool baths.

Anyway, it doesn't sound like you jumped the gun going to the doc at all, good call mama!

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M.H.

answers from Chicago on

My experience is this..

We had to go to the ER in TN (we are from IL). And the doc said that it should be viral, but gave him antibiotics anyhow.????? It seemed that his doc would not have given us a script.

When we go to the doc.. several times I am told it is just viral, let their system work it out.

Also. My doc said that looking at a throat does not always tell the story, it could look like strep and not be, it could not look like it and be, or it could be and look like it should be.. So no, the doc can not always tell.

With that said, it seems that the ER and clinics are more apt to give a script and send you away then your doc is.

Good luck

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J.C.

answers from New York on

I love when people start with F/U, too!! Too funny.

Poor F. B.!! Hang in there. Lots of kids only get sick on rare occasions. Once my daughter contracted everything possible through daycare, she is now rarely sick. So chances are, he's built up some good antibodies.

A doctor should err on the side of caution and not prescribe too many antibiotics. But if he was to suspect strep, he should be checking for it. Fact is, my daughter gets checked once a year for strep - it's only been positive once. She went on antibiotics and felt better in a day. If your child goes on antibiotics and doesn't feel better in a day (max 2) chances are it's viral. Fever doesn't always signify infection. My daughter gets fevers for a day sometimes and it's some virus working it's way out. Next day, she's back to normal.

I used to rush to the doctor more often. Now, it seems like when something comes along, I wait it out a bit and then go. And usually, it's an ear infection or a virus.

Good luck!!

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L.O.

answers from Detroit on

did you go to urgent care?? a walk in clinic../ those places always give you antibiotics.. whereas your regular pediatrician does not always give antibitotics..

My dr said wait 48 hours for a fever.. if they stillhave a fever after 48 hours.. then go to the dr. as soon as my kid spikes a fever.. I call my dr and ask for an appointment in 48 hours.. so they can be seen. I can always cancel if they get better.

yes.. absolutely wait with a cough sneeze.. and see if he improves.. do not run the child to the dr everytime they sniffle.

yes.. use the childs behavior.. a sick kid lays down.. a kid with a cold runs around with a runny nose.

no a dr cannot always tell a virus from a bacterial infectin.. our dr checks ears.. nose and throat if something isn't obviously infected red, pus, then it is a virus and off we go with no drugs and a bill for $85.

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N.L.

answers from Tampa on

I think the "when to take to the doctor" really depends on your child and the scenario.

For fevers, we don't give medication until it goes above 101.5 (per our ped's recommendation). We generally also don't go to the dr unless they've had a consistent fever for about 3 days (also per our ped's recommendation).

That said, we took our oldest to urgent care last weekend b/c after a week with a cold that was getting better, she started crying about her ear hurting. She only had a mild fever, but it was really unlike her to cry about something hurting so we took her in...turned out to be an ear infection. On the other hand, she can have a fever of 104.5 and act only a little tired. Even with a fever that high, we wait it out a few days for the most part. It usually sorts itself out in a few days. I'd say about 30% of the time we end up with a visit to the dr. We DO use behavior as an indicator...as in, something "not normal" for that specific child.

Our ped doesn't rush to give antibiotics. We get the quick test for strep and the lab test results later. Both our girls have a history of ear infections so we do generally get antibiotics for those.

It's tough whether you're a first time mom or not. :) You'll start figuring out things specific to your child (pain tolerance, "warning" signs, etc). Hope your kiddo feels better soon.

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M.S.

answers from Washington DC on

My experience has been that 90% of the time that we go to the doctor, the doctor says its just a virus and needs to run its course. The other 10% of the time they do actually have something they need meds for, like an ear infection, strep, or pink eye or stuff like that. Its natural with your first to be concerned and unsure about when to take them to the doctor, and when to wait. I think we all go through that! You will also get used to what kind of symptoms are normal for YOUR kid. They are all different! My nephew gets strep all the time. So, when he gets sick they know that his voice gets cloggy sounding when he has strep, so they act quickly on taking him to the doctor. My 4 year old has never had strep. But he has had pink eye 10 times! And my 1 year old gets lots of ear infections. So, you do learn what to look for for when they really need to be seen. I dont ever take mine to the doctor for being sick unless the fever is 103+, or lasts more than 2 days. For the most part, there is nothing the doctor can do, as most illnesses are viruses. Taking them to the doctors office only exposes them to more germs! I do agree though, if the doctor suspects strep, I would want the rapid test done to confirm before they write a script. Our ped and every urgent care office in our area offer this test. I was surprised to hear that not everyone does that test.

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