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Tests and diagnosis
By Mayo Clinic staffYour 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
- Gently feeling (palpating) your child's neck to check for swollen glands (lymph nodes)
- Listening to his or her breathing with a stethoscope
Throat swab
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.
- Tonsillopharyngitis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec08/ch090/ch090i.html. Accessed March 21, 2010.
- Fact sheet: Tonsillitis. American Academy of Otolaryngology — Head and Neck Surgery. http://www.entnet.org/HealthInformation/tonsillitis.cfm. Accessed March 21, 2010.
- Tonsillitis. Healthy Children: American Academy of Pediatrics. http://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/pages/Tonsillitis.aspx. Accessed March 21, 2010.
- The difference between a sore throat, strep and tonsillitis. Healthy Children: American Academy of Pediatrics. http://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/pages/The-Difference-Between-a-Sore-Throat-Strep-and-Tonsillitis.aspx. Accessed March 21, 2010.
- Wetmore R. Tonsils and adenoids. In: Kliegman R, et al., eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/193178650-2/0/1608/0.html. Accessed April 5, 2010.
- Fact sheet: Tonsils and adenoids. American Academy of Otolaryngology - Head and Neck Surgery. http://www.entnet.org/HealthInformation/tonsilsAdenoids.cfm. Accessed March 21, 2010.
- Tonsillar cellulitis and abscess. The Merck Manuals: The Merck Manual of Healthcare Professionals. http://www.merck.com/mmhe/sec19/ch222/ch222b.html. Accessed April 5, 2010.
- Streptococcal and enterococcal infections. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec14/ch171/ch171d.html. Accessed March 21, 2010.
- Information from your family doctor. Sore throat. American Family Physician. 2006;74:1185.
- Get smart: Know when antibiotics work. Symptom relief. Centers for Disease Control and Prevention. http://www.cdc.gov/getsmart/antibiotic-use/symptom-relief.html. Accessed April 5, 2010.
- Fact sheet: Tonsils and adenoids post-op. American Academy of Otolaryngology — Head and Neck Surgery. http://www.entnet.org/HealthInformation/tonsilsAdenoidsPostop.cfm. Accessed March 21, 2010.
- Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. April 7, 2010.
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