Strep throat is caused by Group A Streptococcus bacteria. It is the most common bacterial infection of the throat.
Pharyngitis - streptococcal; Streptococcal pharyngitis
Causes, incidence, and risk factors
Strep throat is most common in children between age 5 and 15, although anyone can get it.
Strep throat is spread by person-to-person contact with nasal secretions or saliva. It commonly spreads among family or household members.
Symptoms may be mild or severe. You usually start to feel sick about 2 to 5 days after you come in contact with the bacteria.
Symptoms usually begin suddenly, and can include:
Feverthat begins suddenly and is often highest on the second day
- Red throat, sometimes with white patches
- Sore throat
- General ill feeling
Loss of appetiteand abnormal taste Swollen lymph nodesin the neck
- Difficulty swallowing
Some strains of strep throat can lead to a scarlet fever-like
Signs and tests
A rapid test can be done in most health care provider offices, but misses a few of the cases.
If the rapid strep test is negative and your health care provider still thinks you or your child may have strep, a throat swab can be tested (cultured) to see if strep grows from it. However, it will take one to two days for results to come back.
Most sore throats are caused by viruses, not strep-related bacteria. Strep cannot be accurately diagnosed by symptoms or a physical exam alone. Many of the other causes of sore throats may have the same symptoms.
Sore throats should only be treated with antibiotics if the strep test is positive. Antibiotics are taken to prevent rare but more serious health problems, such as rheumatic fever.
Penicillin or amoxicillin is usually first tried. Antibiotics should be taken for 10 days, even though symptoms are usually gone after few days.
The following tips may help your sore throat feel better:
- Drink warm liquids such as lemon tea or tea with honey.
- Gargle several times a day with warm salt water (1/2 tsp of salt in 1 cup water).
- Drink cold liquids or suck on popsicles.
- Suck on hard candies or throat lozenges. Young children should not be given such products because they can choke on them.
- A cool-mist vaporizer or humidifier can moisten and soothe a dry and painful throat.
- Try over-the-counter pain medications, such as acetaminophen.
Symptoms of strep throat usually get better in about 1 week. Untreated, strep can lead to serious complications.
On rare occasions, strep throat can lead to
Ear infection Sinusitis Mastoiditis Peritonsillar abscess Rheumatic fever Glomerulonephritis Scarlet fever Guttate psoriasis
Calling your health care provider
Call if you develop the symptoms of strep throat. Also, call if you are being treated for strep throat and are not feeling better within 24 - 48 hours.
Most people with strep are contagious until they have been on antibiotics 24 - 48 hours. They should stay home from school, daycare, or work until they have been on antibiotics for at least a day.
Get a new toothbrush after you are no longer contagious, but before finishing the antibiotics. Otherwise the bacteria can live in the toothbrush and re-infect you when the antibiotics are done. Also, keep your family's toothbrushes and utensils separate, unless they have been washed.
If repeated cases of strep still occur in a family, you might check to see if someone is a strep carrier. Carriers have strep in their throats, but the bacteria do not make them sick. Sometimes, treating them can prevent others from getting strep throat.
Gerber MA, Baltimore RS, Eaton CB, et al. Prevention of rheumatic fever and diagnosis and treatment of acute Streptococcal pharyngitis: a scientific statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics. Circulation. 2009 Mar 24;119(11):1541-51.
Chan TV. The Patient with Sore Throat. Med Clin North Am. 2010 Sep;94(5):923-43.
Shaikh N, Leonard E, Martin JM. Prevalence of streptococcal pharyngitis andstreptococcal carriage in children: a meta-analysis. Pediatrics. 2010 Sep;126(3):e557-64.
Del Mar C, Glasziou PP, Spinks A. Antibiotics for sore throat. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD000023.
Altamimi S, Khalil A, Khalaiwi KA, Milner R, Pusic MV, Al Othman MA. Short versus standard duration antibiotic therapy for acute streptococcal pharyngitis in children. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD004872.
This article uses information by permission from Alan Greene, M.D., Greene Ink, Inc.