Strep Throat


Dear DR. Z,

What exactly is Strep Throat, and what should I know about it?

Background

Nearly everyone at some point in their life has complained of a “sore throat.” Sore throats are caused by either viruses or by bacteria, with Streptococcus pyogenes being the most common. Strep throat most commonly affects children between the ages of 5 and 15, but people of all ages can get it. It is highly contagious, typically spread through direct contact such as kissing, sharing drinks, and body fluids.

Signs and Symptoms

Strep throat generally develops rapidly, involving many of the following symptoms:

  • Sudden and severe sore throat with difficulty swallowing
  • Red, enlarged tonsils with yellow or white patches in the back of the throat
  • Neck pain or swollen or tender lymph nodes
  • Fever of 100.5°F or greater
  • Body aches
  • General discomfort, or ill-feeling
  • Bad breath
  • Abdominal pain or nausea
  • Rash
Not everyone fits this textbook description, you may have other respiratory complaints such as a productive cough, runny nose, or red, irritated eyes in addition to a fever and sore throat.

Diagnosis

When you see your doctor, they will most likely ask some generalized questions regarding your illness and then do a physical exam. Numerous studies have found that the best predictors of strep throat include:

  • 1. Swollen or tender lymph nodes
  • 2. Significant amounts of white patches on the back of the throat
  • 3. Fever >100.5°F

If your doctor suspects strep throat, they may perform a Rapid Strep Test in which a sample from the back of your throat is taken with a large Q-tip and the diagnosis can be made in the office. The most specific test involves sending your sample to a laboratory to be cultured. The results of this process can take several days but may be necessary if your doctor highly suggests strep throat but your Rapid Strep Test was negative.


Treatment

Treatment of Strep throat consists of the use of antibiotics. Over the counter ibuprofen and acetaminophen can help relieve both throat pain. If a bacterial infection has been determined, oral treatment of a penicillin-based medication is considered first-line therapy. Make sure to let your doctor know if you are allergic to penicillin or any other antibiotics in the penicillin family, in which case another antibiotic from a different family may be used. Furthermore, you should throw out your toothbrush on the 5th day of being on the antibiotics. You should also gargle with warm salt water two to three times a day, this will reduce the severity of the sore throat. Along with taking the full course of the prescribed medication, ibuprofen and/or acetaminophen can also be given to reduce fever or the discomfort from the sore throat. As with many infections, increasing fluid intake and getting plenty of rest may also help shorten the length of your illness. It is extremely important to treat strep throat completely and adequately otherwise, certain complications may occur. Some of the most common complications of strep throat can include:

  • SCARLET FEVER, which consists of a distinct rash which develops and is formed by toxins which are released by the bacteria.

  • RHEMATIC FEVER, which is a form of heart disease in which the heart muscle becomes inflamed causing scarring of the heart valves.

  • GLOMERULONEPHRITIS, which is a form of kidney disease which may lead to kidney failure.

  • If you have been exposed to strep throat, or are concerned about your sore throat, don’t hesitate to visit your local medical home for further evaluation and treatment.

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