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Group A Streptococcal (Group A Strep) Infections

By: Elizabeth Williams, MD, FAAP

If your child has ever had a throat or skin infection, it may have been caused by group A streptococcal (Group A Strep) bacteria. Group A strep bacteria can be extremely contagious. It can cause a variety of infections, typically mild but occasionally severe.

What infections does group A strep cause?

Strep throat

The most common group A strep infection is strep throat, which usually causes fever and sore throat without viral illness symptoms such as runny nose and cough. Strep throat is especially common among school-aged children and teenagers.

Skin infections

Group A strep organisms can cause skin infections such as impetigo (itchy, red, oozing sores) and cellulitis (red, swollen, painful skin).

Scarlet fever

Group A strep bacteria can cause an infection called scarlet fever. This infection is basically strep throat with a rash, which is caused by a toxin the bacteria releases into the body.

Severe infections

Rarely, group A strep can cause serious infections that require immediate medical attention and even intensive care. These include:

  • Necrotizing fasciitis. Symptoms of this severe skin infection include deep soft-tissue pain and low blood pressure.

  • Streptococcal toxic shock syndrome. Symptoms include low blood pressure, increased heart rate, fast breathing and infections of the blood (sepsis) or lungs (pneumonia).

When to call your pediatrician

If your child has a sore throat, fever and swollen glands, especially without a runny nose or cough, call your pediatrician.

How long is the incubation period for group A strep?

An infected child will usually start feeling sick 2 to 5 days after being exposed to streptococcal bacteria.

How is group A strep diagnosed in children?

If your child has a sore throat and fever without symptoms of viral infection, your health care provider may swab your child's throat to test for Group A Strep infection. Some pediatricians' offices have quick-result strep tests that can help diagnose streptococcal infection in several minutes. A throat culture may be used, but this takes a few days.

How is a group A strep infection treated?

The primary treatment for sore throats caused by Group A Strep is penicillin, an antibiotic that's taken orally. Amoxicillin also works well, and there are other antibiotics that can be used in case of a sever penicillin allergy. Skin infection caused by group A strep may be treated with antibiotic ointment, or sometimes with oral or IV antibiotics.

How long should my child stay home with a group A strep infection?

If your child has a throat or skin infection caused by group A strep bacteria, they can go back to school or child care once they've had two doses of a course of an appropriate antibiotic 12 hours apart without fever.

How can I help my child feel better?

Home remedies such as gargling with warm salt water may relieve some of your child's throat pain. Acetaminophen or ibuprofen or can lower your child's temperature and lessen the pain.

How long does it take to recover from group A strep infection?

When antibiotics are given to treat the most common group A strep infection, most children improve within a few days.

More information

About Dr. Williams

S. Elizabeth Williams, MD, MPH, FAAP, is a board-certified general pediatrician. She is an Assistant Professor in the Department of Pediatrics at Vanderbilt University Medical Center in Nashville, TN, and has a research background in vaccine safety and vaccine education. Within the American Academy of Pediatrics (AAP), Dr. Williams is a member of the Section on Infectious Diseases.

Last Updated
American Academy of Pediatrics Section on Infectious Diseases (Copyright © 2022)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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