Strep Throat

Strep 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. The bacterial cause is more common in children aged 3–13 years, but it affects people of all ages.

• Streptococcus infects the upper respiratory tract and can involve all parts, leading to
• Strep tonsillitis: Tonsillitis is an infection of the tonsils, which are two oval-shaped tissue pads in the back of the throat.
• Strep tonsillopharyngitis:  acute infection of the pharynx, palatine tonsils, or both
• Strep pharyngitis is an inflammation of the pharynx, resulting in a sore throat.
• Strep laryngitis: When your voice box or vocal cords in your throat gets irritated or swollen, it is called laryngitis.

Strep throat is caused by Streptococcus pyogenes, also called Group A streptococcus.

Streptococcal bacteria are contagious. They can spread through 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.

Spread of Infection: Strep bacteria may spread, causing disease in:

• Tonsils
• Sinuses
• Skin
• Blood
• Middle ear

Inflammatory Reactions: Strep infection may lead to inflammatory illnesses, including:

• Scarlet fever is a streptococcal infection characterized by a prominent rash.
• Inflammation of the kidney (post-streptococcal glomerulonephritis)
• Rheumatic fever is a serious inflammatory condition that can affect the heart, joints, nervous system, and skin.
• Post-streptococcal reactive arthritis is a condition that causes inflammation of the joints.

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 winter and early spring. Strep bacteria flourish wherever groups of people are in close contact.

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

The cause of these signs and symptoms could be a viral infection or some other illness.

Your doctor will perform a physical examination, check for signs and symptoms of strep throat, and most likely order one or more of the tests listed below:

Rapid Antigen Test: A swab sample from your throat may be used in a quick antigen test by your doctor. This test can detect strep bacteria in minutes by examining for substances (antigens) in the throat.

PCR Test: If the test is negative, but your doctor still suspects strep, a throat culture may be performed.

Throat Culture: To get a sample of the secretions, a sterile swab is rubbed over the back of the throat and tonsils. It's not painful, but it could make you gag. The sample is then cultured in a lab to see if bacteria are present.

Other tests such as Complete Blood Count (CBC) and blood film. 

The diagnostic features are:

• Constitutional symptoms
•  Fever more than 38c
• Toxicity
• Tender anterior cervical lymphadenopathy (Cervical lymphadenopathy refers to the swelling of lymph nodes located in the neck)
• Absence of cough
• A sore throat that lasts 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

Indications for antibiotic therapy

• Sore throat with no cough but fever more than 38 c
• Tender neck gland and white spots in the throat.
• The first choice of treatment is penicillin or amoxicillin. Doctors can treat strep throat with other antibiotics such as azithromycin in those allergic to penicillin.

Supportive symptomatic treatment:

• Adequate soothing
• Analgesics for adults, such as aspirin Paracetamol for Children
• Rest with adequate fluid intake
• Soothing gargles.

To prevent strep infection:

• Wash your hands. Proper handwashing is the best way to avoid all kinds of conditions. That's why washing your hands regularly with soap and water for at least 20 seconds is essential. Teach your children how to wash their hands properly using soap and water or use an alcohol-based hand sanitizer if no soap and water are available.
• Cover your mouth. Teach your children to cover their mouths with an elbow or tissue when coughing or sneezing.
• Don't share personal items. Don't share drinking glasses or eating utensils. Wash dishes in hot, soapy water or a dishwasher.

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on Nov 14, 2023.

References

https://www.mayoclinic.org/diseases-conditions/strep-throat/symptoms-causes/syc-20350338

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(22)00188-2/fulltext