Your child's doctor will start with a physical exam that will include:
- Using a lighted instrument to look at your child's throat and likely his or her ears and nose, which may also be sites of infection
- Checking for a rash known as scarlatina, which is associated with some cases of strep throat
- Gently feeling (palpating) your child's neck to check for swollen glands (lymph nodes)
- Listening to his or her breathing with a stethoscope
- Checking for enlargement of the spleen (for consideration of mononucleosis which also inflames the tonsils)
With this simple test, the doctor rubs a sterile swab over the back of your child's throat to get a sample of secretions. The sample will be checked in a lab for streptococcal bacteria.
Many clinics are equipped with a lab that can get a test result within a few minutes. However, a second more reliable test is usually sent out to a lab that can return results within 24 to 48 hours.
If the rapid in-clinic test comes back positive, then your child almost certainly has a bacterial infection. If the test comes back negative, then your child likely has a viral infection. Your doctor will wait, however, for the more reliable out-of-clinic lab test to determine the cause of the infection.
Complete blood cell count (CBC)
Your doctor may order a CBC with a small sample of your child's blood. The result of this test, which can often be completed in a clinic, produces a count of the different types of blood cells. The profile of what's elevated, what's normal or what's below normal can indicate whether an infection is more likely caused by a bacterial or viral agent. A CBC is not often needed to diagnose strep throat. However, if the strep throat lab test is negative, the CBC may be needed to help determine the cause of tonsillitis.
Aug. 04, 2012
- Fact sheet: Tonsils and adenoids. American Academy of Otolaryngology — Head and Neck Surgery. http://www.entnet.org/HealthInformation/tonsilsAdenoids.cfm. Accessed April 23, 2012.
- Fact sheet: Tonsillitis. American Academy of Otolaryngology — Head and Neck Surgery. http://www.entnet.org/HealthInformation/tonsillitis.cfm. Accessed April 23, 2012.
- Kliegman RM, et al. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/208746819-6/0/1608/0.html. Accessed April 23, 2012.
- Ferri FF. Ferri's Clinical Advisor 2012:5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05611-3..C2009-0-38601-8--TOP&isbn=978-0-323-05611-3&uniqId=291436269-101. Accessed April 23, 2012.
- McPhee SJ, et al. Current Medical Diagnosis & Treatment 2012. 51st ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=1. Accessed April 22, 2012.
- Tonsillopharyngitis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/ear_nose_and_throat_disorders/oral_and_pharyngeal_disorders/tonsillopharyngitis.html. Accessed April 23, 2012.
- Tagliareni JM, et al. Tonsillitis, peritonsillar and lateral pharyngeal abscesses. Oral and Maxillofacial Surgery Clinics of North America. 2012;24:197.
- Fact sheet: Tonsillectomy procedures. American Academy of Otolaryngology — Head and Neck Surgery. http://www.entnet.org/HealthInformation/tonsillectomyProcedures.cfm. Accessed April 23, 2012.
- Mandell GL, et al. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-443-06839-3..X0001-X--TOP&isbn=978-0-443-06839-3&uniqId=230100505-57. Accessed April 23, 2012.
- Fact sheet: Tonsils and adenoids: PostOp. American Academy of Otolaryngology — Head and Neck Surgery. http://www.entnet.org/HealthInformation/tonsilsAdenoidsPostop.cfm. Accessed April 23, 2012.
- Stopping the spread of germs at home, work and school. Centers for Disease Control and Prevention. http://www.cdc.gov/flu/protect/stopgerms.htm. Accessed June 24, 2012.
- Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. May 15, 2012.
- Orvidas LJ (expert opinion). Mayo Clinic, Rochester, Minn. May 15, 2012.
- Baugh RF, et al. Clinical Practice Guideline: Tonsillectomy in children. Otolaryngology — Head and Neck Surgery. 2011;144:S1.