• Strep Throat

    (Bacterial Sore Throat)

    Definition

    Strep throat is a bacterial throat infection.
    Sore Throat Due to Inflammation
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Strep throat is caused by the bacterium Streptococcus pyogenes. It is spread by airborne droplets, most often from:
    • Coughing and sneezing of people who have strep throat
    • Touching a contaminated surface and then touching your eyes, nose, or mouth

    Risk Factors

    A risk factor is something that increases your chance of getting a disease or condition.
    Risk factors for strep throat include:
    • Age: school-aged children
    • Family member or friend who has strep throat

    Symptoms

    Symptoms of strep throat include:
    • Red, sore throat with white patches
    • Painful, difficult swallowing
    • Chills
    • Headache
    • Swollen, sore glands in the neck
    • Fever
    • Nausea and possibly vomiting
    • Decreased appetite
    • Rash
    • Muscle aches, especially in the neck, and abdominal pains, especially in younger children
    • Fatigue

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests to detect strep throat may be used and include:
    • Throat culture—Sample of throat secretions is cultured in the laboratory. It takes a few days to gets results.
    • Rapid antigen strep screen—The results are available in minutes. The test is based on detection of antigens; however, a negative test does not exclude the diagnosis of strep throat.
    • Rapid DNA test—Using DNA technology to detect strep throat, this test is as accurate as throat culture. The results are usually available in one day.
    While only a, rapid DNA test or throat culture can confidently distinguish strep throats from those caused by virus infection, doctors will make a diagnosis and decide about treatment primarily by careful evaluation of symptoms and physical findings.

    Treatment

    Antibiotic Medications

    Almost all sore throats—including strep—will get better on their own in 7-10 days. Strep throat improves more rapidly with antibiotics than without. (Antibiotics do not affect the healing of sore throats due to virus infection.) Given as a pill or a shot, types of antibiotics include penicillin, amoxicillin, erythromycin, azithromycin, or cephalosporin antibiotics. Symptoms begin to disappear after only a few doses, but it is crucial that you finish the entire prescription.
    Serious complications of undertreated strep throat include:
    Antibiotics are typically given to prevent the complication of rheumatic fever from occurring after strep throat infection. In many communities, neither azithromycin nor erythromycin are reliably effective in treating strep throat or preventing rheumatic fever due to resistance of the bacteria.

    Over-the-Counter Pain Medications

    Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help relieve sore throat and muscle aches and pains.
    Note: Aspirin is not recommended for children or teens with a current or recent viral infection. This is because of the risk of Reye's syndrome. Ask your doctor which other medicines are safe for your child.
    If your are diagnosed with strep throat, follow your doctor's instructions.

    Prevention

    To reduce your chances of getting strep throat:
    • Wash your hands carefully.
    • Don't share beverages or food.

    RESOURCES

    American Academy of Otolaryngology—Head and Neck Surgery http://www.entnet.org

    Familydoctor.org http://familydoctor.org

    CANADIAN RESOURCES

    About Kids Health http://www.aboutkidshealth.ca

    Health Canada http://www.hc-sc.gc.ca

    References

    American Academy of Otolaryngology–Head and Neck Surgery website. Available at: http://www.entnet.org . Accessed October 12, 2005.

    Cecil RL, Goldman L, Bennett JC. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: WB Saunders Company; 2000.

    Ebell MH, Smith MA, Barry HC, Ives K, Carey M. Does the patient have strep throat? JAMA. 2000; 284:2912-2918.

    Montagnani F, Stolzuoli L, Croci L, et al.Erythromycin resistance in Streptococcus pyogenes and macrolide consumption in a central Italian region. Infection. 2009 Aug;37(4):353-357.

    Neuner JM, Hamel MB, Phillips RS, Bona K, Aronson MD. Diagnosis and management of adults with pharyngitis. A cost effectiveness study. Ann Intern Med. 2003;139:113-122.

    Ressel G. Practice guidelines: principles of appropriate antibiotic use: part IV: acute pharyngitis. Am Fam Physician . 2001;64(5).

    Strep throat. JAMA. 2000 Dec 13.

    Strep throat. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/strep-throat/DS00260 . Accessed November 10, 2007.

    Streptococcal pharyngitis. DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Accessed November 10, 2007.

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