Strep Throat: Symptoms, Causes, Diagnosis, and Treatment

Strep Throat

What Is Strep Throat?

Strep throat is an infection of the throat and tonsils caused by a bacteria called group A streptococcus , also known as Streptococcus pyogenes. This bacteria lives in the nose and throat. You can get the infection from someone who is sick with strep A bacteria or is a carrier of it.

Strep Throat Symptoms

A sore throat is the main sign you or your child has strep. Colds and other viruses can also cause a sore throat. One way to tell the difference is that a virus will often cause a runny nose too.

With strep, the sore throat comes on quickly and is more likely to cause these other symptoms as well:

  • A fever of 101 F or higher

  • Red, swollen tonsils

  • Pain when you swallow

  • Swollen and/or tender lymph nodes at the front of your neck

  • White patches in the throat

  • Tiny red spots on the roof of the mouth (called petechiae)

  • Appetite loss

  • Stomachache

  • Headache

  • Body aches

  • Nausea, vomiting

  • Loss of appetite

  • Rash

Call your doctor if you or a child in your care has these symptoms.

Signs that the infection might be viral rather than strep include having a:

  • Cough

  • Runny nose

  • Hoarse voice

  • Pinkeye (also called conjunctivitis)

Strep Throat Causes

Like other infections, strep throat spreads through close contact. When people who are sick cough or sneeze, they release droplets that hold the bacteria into the air.

You can infect yourself if you touch something a person with strep has coughed or sneezed upon and then brush your eyes, mouth, or nose with your hand. You can also get sick if you share a glass or other personal item with someone who has strep.

Strep is most common in children and teens. Adults sometimes get it too.

Strep Throat Diagnosis

Your doctor will ask about your child's symptoms. The only sure way to tell strep from viruses that cause a sore throat is with a test. There are two kinds:

Rapid strep test: It can identify a case in just a few minutes. The doctor will gently hold down your child's tongue with a depressor. Then, they will use a cotton swab to take a sample from the back of the throat.

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You'll get the results in 20 minutes or less. If the test is positive, which means strep is there, the doctor will prescribe antibiotics to treat it.

If the test is negative, which means the strep bacteria could not be found, the doctor might send the sample to a lab for a follow-up that takes longer.

Throat culture: The doctor will rub a swab over the throat and tonsils to be sent to the lab. If your child has strep throat, streptococci bacteria will grow in it.

It usually takes about 2 days to get results from a throat culture. It can confirm whether your child has strep throat or not.

Strep Throat Treatments and Home Care

Medications

Your doctor will prescribe antibiotics to kill the bacteria that cause the infection. Most treatments last for about 10 days. The medicine can make your child's symptoms go away faster and help prevent complications.

Make sure your child takes all of the doses. Stopping the medicine too early can leave some bacteria alive. These can make your child sick again. Be sure to tell the doctor if your young one is allergic to any types of antibiotics.

If the strep test is negative, a virus likely caused the sore throat. Your child doesn't need antibiotics because these medications don't work on viruses.

You can also take medications to ease the pain of strep throat and lower fever including over-the-counter medications such as ibuprofen or acetaminophen. Don't give aspirin to children or teens. It can cause a rare but dangerous condition called Reye’s syndrome.

Home care

There are a number of things you can do at home to lessen pain and make you feel more comfortable:

  • Gargle with a mixture of a quarter-teaspoon of salt and 8 ounces of warm water.

  • Suck on a throat lozenge or piece of hard candy. Don't give small pieces of candy to children younger than 4.

  • Throw out your toothbrush and use a new one.

  • Drink warm liquids such as tea and broth and drink plenty of water to prevent dehydration

  • Suck on something cold such as an ice pop or ice chips.

  • Choose soft foods that are easy to swallow such as soups, applesauce, or oatmeal. Pass on orange juice and other drinks that have a lot of acid. They'll sting.

  • Honey can help ease pain and inflammation.

  • Use a humidifier and/or saline nasal sprays to keep your airways moist, which will help you feel more comfortable.

  • Get lots of restso that your body can recover from the infection

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Strep Throat Prevention

Have your child stay home from school or day care until the fever is gone and they have been on an antibiotic for at least 24 hours. Same for you and the workplace. Other tips:

  • Don't share cups, dishes, forks, or other personal items with someone who's sick.

  • Ask children to cover their mouths with a tissue or sleeve whenever they cough or sneeze.

  • Have everyone in the house wash their hands or use an alcohol-based hand sanitizer many times daily.

Strep Throat Complications

Strep complications are rare today, thanks to better diagnosis and treatment. Yet untreated strep can cause serious diseases, such as:

  • The infection spreading to the tonsils, sinuses, middle ear, the mastoid bone behind the ear (mastoiditis), skin or blood

  • Abscess around the tonsils or behind the throat. Called a peritonsillar abscess, it’s a collection of pus that can be extremely painful.

Other strep complications involve an inflammatory response in different parts of your body, including:

  • Scarlet fever, a red rash that can be small tiny pin pricks that are hard to see or intense redness on the body that gives it its name

  • Rheumatic fever, which can damage the heart, brain, and joints

  • A kidney disease called glomerulonephritis

  • Poststreptococcal reactive arthritis, which is inflammation in your joints

Another rare complication that is not well understood is a condition called PANDAS, which stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. It usually involves developing the tics and habits of obsessive compulsive disorder (OCD) after a strep infection or having symptoms of OCD worsen after a strep infection.

Guttate psoriasis, a skin condition in which tear drop scales appear on the surface of the skin. They may be red or silver in color and can be itchy.

 
WebMD Medical Reference Reviewed by Brunilda Nazario, MD on September 27, 2020

Sources

SOURCES:

American Academy of Family Physicians: "Strep Throat Diagnosis & Tests."

American Academy of Pediatrics: "Choking Prevention."

American Association for Clinical Chemistry: "Strep Throat Test."

CDC: "Is It Strep Throat?"Strep Throat: All You Need to Know.”

Cleveland Clinic: "Strep Throat."

Nemours Foundation: "Strep Throat."

PubMed Health: "Strep Throat," "Strep Throat: Treatments."

Seattle Children's Hospital: "Strep Throat."

MedLine Plus: “Mastoiditis.”

Medline Plus: “Guttate psoriasis.”

Mayo Clinic: “Strep Throat,” “Scarlet Fever.”

Penn Medicine: “6 At-Home Remedies for Your Sore Throat.”

University of Utah Health: 4 Tell-Tale Signs You Have Strep Throat.”

Kids Health From Nemours: “Strep Throat.”

American Family Physician: “Peritonsillar Abscess.”

National Institute of Mental Health: PANDAS - Questions and Answers.”

 

 
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