Strep throat

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

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 it affects people of all ages. If you or your child has signs or symptoms of strep throat, see your doctor for prompt testing and treatment.

Symptoms

Signs and symptoms of strep throat can include:

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

It’s possible for you or your child to have many of these signs and symptoms but not have strep throat. The cause of these signs and symptoms could be a viral infection or some other illness. That’s why your doctor generally tests specifically for strep throat.

It’s also possible for you to be exposed to a person who carries strep but shows 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 glands
  • A sore throat that lasts longer than 48 hours
  • A fever higher than 101 F (38.3 C) in older children, or fever lasting longer than 48 hours
  • A sore throat accompanied by a rash
  • Problems breathing or swallowing
  • If strep has been diagnosed, a lack of improvement after taking antibiotics for 48 hours

Causes

The cause of strep throat is bacteria known as Streptococcus pyogenes, also known as group A streptococcus.

Streptococcal bacteria are highly contagious. They can spread through airborne droplets when someone with the infection coughs or sneezes, or through shared 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

Several factors can increase your risk of strep throat infection:

  • Young age. Strep throat occurs most commonly in children.
  • Time of year. Although strep throat can occur anytime, it tends to circulate in late fall and early spring. Strep bacteria flourish wherever groups of people are in close contact.

Complications

Although strep throat isn’t dangerous, it can lead to serious complications. Antibiotic treatment reduces the risk.

Spread of infection

Strep bacteria may spread, causing infection in:

  • Tonsils
  • Sinuses
  • Skin
  • Blood
  • Middle ear

Inflammatory reactions

Strep infection may lead to inflammatory illnesses, including:

  • Scarlet fever, a streptococcal infection characterized by a prominent rash
  • Inflammation of the kidney (poststreptococcal glomerulonephritis)
  • Rheumatic fever, a serious inflammatory condition that can affect the heart, joints, nervous system and skin

Researchers are investigating a possible link between strep infection and a rare condition called pediatric autoimmune neuropsychiatric disorder associated with group A streptococci (PANDAS). PANDAS is a term used to describe certain children whose symptoms of neuropsychiatric conditions, such as obsessive-compulsive disorder or tic disorders, are worsened by strep infection.

Diagnosis

Your doctor will conduct 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 will likely first 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 still suspects strep, he or she might do a throat culture.
  • Throat culture. A sterile swab is rubbed over the back of the throat and tonsils to get a sample of the secretions. It’s not painful, but it may cause gagging. The sample is then cultured in a laboratory for the presence of bacteria, but results can take as long as two days.

Treatment

Medications are available to cure strep throat, relieve its symptoms, and prevent its complications and spread.

Antibiotics

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

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

Children taking an antibiotic who feel well and don’t have a fever often can return to school or child care when they’re no longer contagious — usually 24 hours after beginning treatment. But be sure to finish all the medicine. Stopping early can lead to recurrences and serious complications, such as rheumatic fever or kidney inflammation.

Symptom relievers

To relieve 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. Though aspirin is approved for use in children older than age 3, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye’s syndrome, a rare but potentially life-threatening condition, in such children.

Sources: Mayo Clinic

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