• Strep Throat

    (Bacterial Sore Throat)

    Definition

    Strep throat is pain, redness, or pus in the back of the throat.
    Sore Throat Due to Inflammation
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Strep throat is caused by streptococcal (strep) bacteria. The strep bacteria is spread by airborne droplets. This occurs with coughing or sneezing from infected people, or by touching a contaminated surface then touching your eyes, nose, or mouth. The droplets can also be inhaled.

    Risk Factors

    Strep throat is more common in children and adolescents. Other factors that increase your chance of strep throat include:
    • Exposure to family member or friend who has strep throat
    • Crowded living situations
    • Having strep living in the throat—occurs in a large segment of the population

    Symptoms

    Strep throat may cause:
    • Red, sore throat with white patches
    • Headache
    • Swollen, sore glands in the neck
    • Fever
    • Red spots on the roof of the mouth
    • Painful, difficult swallowing
    • Chills
    • Fatigue
    • Nausea and possibly vomiting
    • Decreased appetite
    • Rash
    • Muscle aches, especially in the neck, and abdominal pains, especially in younger children
    • Swelling in back of mouth
    Complications of untreated strep throat can be serious and include:
    Post-streptococcal glomerulonephritis (kidney damage) is also rare, but it can occur, even with treatment

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests to confirm strep throat may be used and include:
    • Rapid antigen strep screen—Antigens are a part of the body's immune response to specific infection. This test can identify antigens within a few minutes of the test. However, a negative test does not mean you do not have strep throat (this is called a false negative).
    • Throat culture—A sample of throat fluid is taken to a lab to see if strep bacteria grows. It takes a few days to gets results.
    • Rapid DNA test—DNA technology is used to detect strep throat. The results are usually available in one day.
    Only a rapid DNA test or throat culture can confidently distinguish strep throat from throat infections with other causes. Doctors will often make a diagnosis and decide about treatment based on symptoms, physical findings, and test results.

    Treatment

    Most sore throats, including strep throat, will get better on its own in 7-10 days. Although the sore throat disappears, the infection may remain. It is important to follow through with proper treatment to prevent serious complications.

    Medications

    Your doctor will prescribe antibiotics to treat the infection. Antibiotics may be given as a pill or a shot. Symptoms will often fade in the first few days of medication, but it is important to take all of the antibiotics as prescribed.
    Your doctor may advise over-the-counter pain relievers and fever reducers to ease symptoms.
    Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.

    Prevention

    To help reduce your chances of strep throat:
    • Wash your hands carefully and often.
    • Do not share beverages or food.
    • Avoid exposure to other people who may have a strep infection.
    • Replace your toothbrush after starting antibiotic treatment to prevent re-infecting yourself.

    RESOURCES

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

    Family Doctor—American Academy of Family Physicians https://familydoctor.org

    CANADIAN RESOURCES

    About Kids Health—The Hospital for Sick Children http://www.aboutkidshealth.ca

    Health Canada https://www.canada.ca

    References

    Choby BA. Diagnosis and treatment of streptococcal pharyngitis. Am Fam Physician. 2009;79(5):383-390.

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

    Sore throat. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/ear,-nose,-and-throat-disorders/approach-to-the-patient-with-nasal-and-pharyngeal-symptoms/sore-throat. Updated March 2016. Accessed September 27, 2017.

    Sore throats. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/content/sore-throats. Accessed September 27, 2017.

    Streptococcal pharyngitis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115782/Streptococcal-pharyngitis. Updated July 20, 2016. Accessed September 27, 2017.

    Revision Information

    • Reviewer: EBSCO Medical Review Board Marcie L. Sidman, MD
    • Review Date: 09/2017
    • Update Date: 08/10/2015
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