My 3-year-old son has had strep throat twice. Is this normal or should I be concerned?

Answer From Elizabeth Ristagno, M.D.

Recurrent strep throat isn't likely a sign of an underlying problem with a child's immune system. Children who develop strep throat repeatedly may have contact with a carrier of strep, likely at home or in a child care setting — or they may be strep carriers themselves. A strep carrier is someone who has the strep-causing bacteria, but who is not having symptoms.

Strep throat is an infection caused by a bacterium known as Streptococcus pyogenes, also called group A streptococcus. Strep throat can occur at any age, even during infancy. However, strep throat is most common in school-age children.

Children who develop strep throat may have signs and symptoms including:

  • Irritability
  • Fever
  • Refusal to eat or feed
  • Swollen glands in the neck
  • Red, swollen tonsils or throat
  • Headache
  • Stomachache
  • Nausea or vomiting
  • A fine, red rash on the torso, arms and legs

Testing for strep throat isn't usually recommended in children younger than age 3, as the infection doesn't occur often in this age group. Strep throat may be diagnosed with a rapid antigen test, a molecular test (PCR) or a throat culture.

Treatment for strep throat is typically a course of antibiotics. Recurrent strep throat may be treated with a different antibiotic from the one prescribed originally. In some cases, surgery to remove the tonsils (tonsillectomy) may be the most appropriate treatment.


Elizabeth Ristagno, M.D.

June 27, 2023 See more Expert Answers