From the Guidelines
Strep throat can occur in infants, although it is less common in this age group compared to older children. The diagnosis and management of group A streptococcal pharyngitis in infants can be challenging due to the non-specific symptoms, such as fever, irritability, and poor feeding, which can make it difficult to distinguish from other viral infections 1. Infants with strep throat may not exhibit the typical symptoms of sore throat, but rather may show signs of swollen glands, red throat, or rash. If strep is suspected in an infant, a doctor will perform a rapid strep test or throat culture to confirm the diagnosis.
- Treatment typically involves antibiotics, and it is essential to complete the full course of treatment to prevent complications like rheumatic fever or kidney inflammation.
- According to the Infectious Diseases Society of America, performing routine throat cultures or rapid antigen testing for asymptomatic patients after completion of antibiotic therapy for group A streptococcal pharyngitis is not necessary unless special circumstances are present 1.
- It is crucial for parents to seek medical attention if their infant has a persistent fever, seems very ill, or shows signs of dehydration, as infants can deteriorate quickly when sick.
- The American Academy of Pediatrics recommends that infants with strep throat be treated with antibiotics, such as amoxicillin or penicillin, to prevent complications and reduce the risk of transmission to others 1.
From the Research
Strep Infections in Infants
- Strep infections can occur in infants, with Group B streptococci (GBS) being a common cause of serious and life-threatening infections in neonates 2.
- GBS infections in neonates can manifest as sepsis, pneumonia, meningitis, osteomyelitis, and/or septic arthritis, with early-onset disease (EOD) occurring in the first week of life and late-onset disease (LOD) occurring between 7 and 89 days of life 2.
- Invasive GBS infections can result in significant neurodevelopmental injury and long-term disability, with globally, EOD and LOD occurring in more than 300,000 neonates and infants annually, resulting in 90,000 infant deaths and leaving more than 10,000 infants with a lifelong disability 2.
Group B Streptococcus
- Group B Streptococcus (Streptococcus agalactiae) is a Gram-positive coccus that can be found in 20% of healthy women as part of normal gastrointestinal and genital tract flora 3.
- GBS is associated with pathogenicity in immunocompromised, elderly, and pregnant adults, as well as infants and neonates 3.
- GBS remains a continuing source of morbidity and mortality in high-risk populations, including pregnant women, neonates, and the elderly, with an increasing incidence of invasive disease observed in nonpregnant adults 4.
Treatment and Prevention
- Penicillin G remains the mainstay of therapy for GBS infections, although reduced penicillin susceptibility has been observed in select isolates 4.
- Intrapartum antibiotic prophylaxis has reduced the incidence of early-onset neonatal disease, but has not had a notable impact on the incidence of late-onset neonatal disease 4.
- The development and implementation of strategies to identify hosts, treat judiciously with antimicrobials with the narrowest spectra, and prevent invasive disease, with vaccines, are essential to reduce the burden of GBS disease 4.