An Overview of Strep Throat

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Strep throat, characterized by a sore throat and fever, is a contagious infection caused by group A Streptococcus bacteria (Streptococcus pyogenes). It is a common illness that typically affects children ages 5 to 15, although anyone can get it. Clinicians may suspect strep based on signs an symptoms, such throat swelling, but diagnosis requires a rapid strep test or throat culture. The infection typically improves on its own but is typically treated with prescription antibiotics. Discomfort may be alleviated by other medications or home remedies. Strep throat can progress and cause complications, such as rheumatic fever, but this is rare.

Symptoms

There are a number of symptoms of strep throat, the most common of which is an extremely sore throat.

If you have strep throat, you may develop some or all of these symptoms two to five days after exposure:

  • Difficulty swallowing or pain when swallowing
  • High fevers
  • Chills
  • Fatigue
  • Headaches
  • Loss of appetite
  • Abdominal pain

Causes

Strep throat is spread from one person to another through saliva or secretions that harbor group A Streptococcus bacteria. You can become sick with a strep throat infection if you have been exposed to the bacteria, which is spread through coughing, sneezing, and by touching people or objects that have the bacteria on the surface. Those, especially at risk for getting strep throat if exposed, include anyone who has an immune system deficiency, anyone receiving chemotherapy, very young babies, and pregnant women.

If someone in your household has strep throat, avoid sharing personal items, like towels, drinking cups, eating utensils, and so on. Washing items in hot water can help prevent transmission, as can regular hand washing.

Diagnosis

Strep throat can be diagnosed by your primary care physician or otolaryngologist (ENT doctor).  Diagnosis of strep throat is based on your medical history, your symptoms, a physical examination, and laboratory testing.

You may have several clinical signs of strep throat if you have the infection:

  • Redness, swelling, or white patches that look like pus in the throat or tonsils
  • A rash on your body that begins on the neck and chest 
  • Petechiae (red spots on the roof of the mouth)
  • Tonsillitis
  • Swollen lymph nodes 

There are two commonly used diagnostic tests for strep throat. 

  • The rapid strep test uses a sample of saliva from the back of your throat. The results may be ready within minutes, but the test can produce a false negative.
  • A throat culture involves sending a sample of tissue from the back of your throat to a laboratory to evaluate for bacterial growth. The results take several days to come back, and this is considered the more accurate test.

Treatment

Strep throat is treated using antibiotics. Amoxicillin, penicillin, cephalosporin, clindamycin, clarithromycin, and azithromycin(commonly called the Z-pack) are commonly prescribed. What's recommended for you depends on your case and whether or not you have any related medication allergies. Strep throat can be resistant to some antibiotics, so your doctor may need to change your prescription if you do not improve as expected.

You are no longer contagious after 24 hours of antibiotic treatment.

It is important to take your antibiotic prescription exactly as directed and to finish all of the medication. Many people do not know that taking only partial strep throat treatment can lead to serious complications. Symptoms of strep throat, such as fevers, muscle aches, and headaches can be managed using over-the-counter or prescription medications, such as ibuprofen.

Strep throat is a common infection. However, most of the time, a sore throat is instead caused by a viral infection, which does not improve with antibiotics. Because of this, and concerns with using antibiotics being unnecessary, your doctor will want to confirm a true bacterial infection before prescribing such medication.

A Word From Verywell

If you have strep throat, be sure to get plenty of rest, stay hydrated, and keep eating well, even if swallowing is painful. Give your body the break and tools it needs to recover.

Your doctor will give you advice about when you can resume activities, such as school or work, without running the risk of infecting others. Even if you're feeling better, follow such recommendations to not only protect those around you but ensure that you are well enough to resume your normal routine.

Overall, you should not expect to experience serious long-term consequences with strep throat, and you should expect to improve within a week. If your symptoms do not improve or if they worsen, contact your doctor's office. 

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