Strep throat

Description

Strep throat is a bacterial infection that can make your throat feel sore and itchy. Strep throat accounts for only a small portion of sore throat.

If untreated, strep throat can cause complications, such as kidney inflammation or rheumatic fever. Rheumatic fever can lead to painful and inflamed joints, a specific type of rash, or heart valve damage.

Strep throat is most common in children, but also affects people of all ages. If you or your child has signs or symptoms of strep throat, see your doctor for tests and treatment.

Symptoms

The signs and symptoms of strep throat can include:

  • Throat pain that usually comes on quickly
  • Pain when swallowing.
  • Red and swollen tonsils, sometimes with white patches or streaks of pus
  • Small red spots on the area at the back of the roof of the mouth (soft or hard palate)
  • Swollen, tender lymph nodes in the neck
  • Fever
  • Headache
  • Eruption
  • Nausea or vomiting, especially in younger children
  • Pain in the body

It is possible that you or your child have many of these signs and symptoms, but do not have strep throat. The cause of these signs and symptoms can be a viral infection or some other disease. That is why your doctor generally tests specifically for strep throat.

It is also possible that you will be exposed to a person that leads to strep throat, but displays no symptoms.

When to see a doctor

Call your doctor if you or your child has any of these signs and symptoms:

  • A sore throat accompanied by tender, swollen lymph nodes
  • A sore throat that lasts for more than 48 hours
  • A fever
  • A sore throat accompanied by a rash
  • Trouble breathing or swallowing
  • If strep has been diagnosed, the lack of improvement after taking antibiotics for 48 hours

Causes

Strep throat is caused by infection with a bacterium known as Streptococcus pyogenes, also called group a streptococcus.

The streptococcal bacteria are contagious. They can spread through airborne droplets when someone with the infection coughs or sneezes, or through the sharing of food or drinks. You can also pick up the bacteria from a doorknob or other surface and transfer them to your nose, mouth or eyes.

Risk factors

There are several factors that may increase your risk of infection of strep throat:

  • The young age. Strep throat occurs most commonly in children.
  • The time of year. Although strep throat can occur at any time, it tends to move in the winter and early spring. Strep bacteria bloom where groups of people who are in close contact.

Complications

Strep throat can lead to serious complications. Antibiotic treatment reduces the risk.

The spread of the infection

Strep bacteria can spread, the cause of the infection:

  • Tonsils
  • Sinuses
  • Skin
  • The blood
  • Middle ear

Inflammatory reactions

Streptococcal infection can lead to inflammatory diseases, including:

  • Scarlet fever is a streptococcal infection is characterized by a major eruption
  • Inflammation of the kidney (poststreptococcal glomerulonephritis)
  • Rheumatic fever, a serious inflammatory disease that can affect the heart, joints, the nervous system and the skin
  • Poststreptococcal reactive arthritis, a condition that causes inflammation of the joints

A possible relationship has been suggested between the streptococcal infection and a rare condition called pediatric autoimmune neuropsychiatric disorder associated with group a streptococcus (PANDAS). Children with this condition experience a worsening of symptoms of neuropsychiatric disorders, such as obsessive-compulsive disorder or tic disorders, with streptococci. This relationship in the present continues to be tested and controversial.

Prevention

To prevent the strep infection:

  • Wash your hands. Proper hand washing is the best way to prevent all kinds of infections. That is why it is important to wash your hands regularly with soap and water for at least 20 seconds. Teach your children to wash their hands properly with soap and water or use an alcohol-based hand sanitizer if soap and water are not available.
  • Cover your mouth. Teach your children to cover their mouth with an elbow or a tissue when they cough or sneeze.
  • Do not share personal items. Do not share drinking glasses or eating utensils. Washing dishes with hot, soapy water or in the dishwasher.

Strep throat

Diagnosis

Your doctor will perform a physical exam, look for signs and symptoms of strep throat, and probably order one or more of the following tests:

  • Rapid antigen test. Your doctor can perform a rapid antigen test on a swab sample from your throat. This test can detect strep bacteria in minutes by looking for substances (antigens) in the throat. If the test is negative but your doctor suspects strep, he or she might do a throat culture.
  • Molecular (polymerase chain reaction or PCR) test . This test also makes use of a swab sample from your throat.
  • Throat culture. A sterile swab is rubbed on the back of the throat and tonsils to get a sample of secretions. It is not painful, but can cause nausea. The sample is grown in a laboratory to determine the presence of bacteria, but the results can take up to two days.

Treatment

There are medicines to cure strep throat, relieve your symptoms and prevent its complications and spread.

Antibiotics

If your doctor diagnoses you or your child with strep throat, your doctor will likely prescribe an oral antibiotic. If taken within 48 hours of the onset of the disease, antibiotics reduce the duration and severity of symptoms, as well as the risk of complications and the likelihood of the infection spreading to others.

With the treatment, you or your child should start feeling better in a day or two. Call your doctor if there is no improvement after taking antibiotics for 48 hours.

The children taking an antibiotic that feels good and not have a fever, you can often return to school or child care when they are no longer contagious — usually 24 hours after the start of the treatment. But make sure you finish the medication. Stop time can lead to recurrence and serious complications, such as rheumatic fever or kidney inflammation.

Symptom relievers

To alleviate throat pain, and reduce fever, try over-the-counter pain relievers, such as ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others).

Use caution when giving aspirin to children or teenagers. Even though aspirin is approved for use in children older than 3 years of age, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked with Reye's syndrome, a rare but potentially fatal in these children.

Self-care

In most cases, antibiotics will quickly wipe out the bacteria causing the infection. In the meantime, try these tips to relieve the symptoms of strep throat:

  • Get enough rest. Sleep helps your body to fight infection. If you have a throat infection, stay home if you can. If your child is sick, keep them home until there is no sign of a fever, and he or she feels better and has taken an antibiotic for at least 24 hours.
  • Drink lots of water. Maintain a sore throat lubricated and moist facilitates swallowing and helps prevent dehydration.
  • Eat soothing foods. Easy to swallow foods include broths, soups, applesauce, cooked cereal, mashed potatoes, soft fruits, yogurt and soft-boiled eggs. You can puree food in a blender to make them easier to swallow. Cold foods, such as sorbet, frozen yogurt or frozen fruit pops can also be relaxing. Avoid spicy foods or acidic foods such as orange juice.
  • Gargle with warm salt water. For older children and adults, gargle several times a day can help relieve a sore throat. Mix 1/4 teaspoon (1.5 grams) of salt in 8 ounces (237 milliliters) of warm water. Be sure to tell your child to spit out the liquid after you gargle.
  • Honey. Honey can be used to soothe a sore throat. Do not give honey to children under the age of 12 months.
  • The use of a humidifier. The addition of moisture in the air can help to relieve the discomfort. Choose a cool-mist humidifier and clean it daily because the bacteria and molds can flourish in some humidifiers. Saline nasal sprays also help to keep the mucous membranes moist.
  • Stay away from irritants. Cigarette smoke can irritate a sore throat and increase the likelihood of infections such as tonsillitis. Avoid the fumes from paint or cleaning products, which can irritate the throat and lungs.

Preparing for your appointment

What you can do

When you make the appointment, ask if there is something that you need to do in advance, such as fasting before a specific test. Make a list of:

  • The symptoms you or your child , including those that seem unrelated to the reason for your appointment
  • Key personal information , including major stresses, recent life changes, family medical history and potential sources of recent infection
  • All medications, vitamins or supplements that you or your child takes, including the dose
  • Questions to ask your doctor

Take along a family member or a friend, if possible, to help you remember the information they give you.

For strep throat, some basic questions to ask your doctor include:

  • What is likely the cause of these signs and symptoms?
  • What are other possible causes?
  • What tests are needed?
  • What treatment approach do you recommend?
  • How soon do you expect that the symptoms improve with treatment?
  • How long will this be contagious? When it is safe to return to school or to work?
  • What self-care steps can help?
  • Is there a generic alternative to the medicine you're prescribing?

Do not hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask a series of questions, including:

  • When did the symptoms begin?
  • The symptoms changed over time?
  • How severe are the symptoms?
  • Have you or your child has been exposed to someone with strep throat in the last couple of weeks?
  • Does nothing seem to symptoms better or worse?
  • Have you or your child has been diagnosed with inflammation of the throat in the past? When? How is it treated?
  • Have you or your child has been diagnosed with any other medical condition?

What you can do in the meantime

If you think that you or your child may have a strep infection, take steps to alleviate the symptoms and prevent the spread of infection:

  • Keep your hands clean, cover the mouth when coughing or sneezing, and not sharing personal items.
  • Gargle with 1/4 teaspoon (1.5 grams) of salt in 8 ounces (237 milliliters) of warm water.
  • Rest, drink fluids, eat soft foods and take pain relievers, such as ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others) to help relieve the symptoms.
Symptoms and treatment of Streptococcal pharyngitis