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Strep Throat

Alternate Names

  • streptococcal pharyngitis
  • Pharynx

Definition

Strep throat is an infection of the pharynx caused by the bacteria Streptococcus pyogenes (also known as group A strep). The pharynx is the part of the throat between the tonsils and the larynx, or voice box.

What is going on in the body?

Strep throat is the most common of the many infections that are caused by group A streptococci (GAS). The bacteria that cause strep throat make a toxin that results in an inflammation in the throat and tonsils. A person can develop symptoms of strep throat from 1 to 6 days after being exposed to the bacteria.
Symptoms in up to 40% of children may be too mild to come to the attention of a healthcare professional. Up to 20% of school-aged children may be carriers of the bacteria. These children will show no symptoms but can transmit strep throat to others. Strep throat is more significant than sore throats caused by viruses because of the likelihood of complications is higher.

Risks

What are the causes and risks of the disease?

Strep throat is a bacterial infection that is usually spread by person-to-person contact through coughing or sneezing. Exposure to a person who has untreated strep throat may pose a risk for acquiring this infection. A person may be a carrier of the strep bacteria without having symptoms.
People who may be more at risk for serious strep infection include:
  • people who have chronic conditions or diseases such as diabetes
  • people who have weakened immune systems, such as those with HIV or other immunodeficiency disorders
  • children who have chickenpox

Prevention

What can be done to prevent the disease?

Strep throat can be spread from person to person. Prompt diagnosis and treatment is the best way to prevent the disease and its complications. Anyone with strep throat should take antibiotics for at least 24 hours before returning to work, school, or day care. In addition, hands should be washed thoroughly and soiled tissues should be discarded promptly.

Diagnosed

How is the disease diagnosed?

Strep throat may be suspected after a medical history and physical exam are performed. However, even in persons who have typical symptoms and findings of strep throat, it is not possible to distinguish strep throat from a viral infection on the basis of history and physical alone. Thus, it is necessary to swab the back of the throat to get a sample of the bacteria to guide the treatment.
Tests that may be done on this sample are:
  • a rapid chemical test for streptococcal antigen, which makes it possible to make the diagnosis within minutes
  • throat culture, which involves the growing of bacteria in the lab and takes at least 24 hours
Blood tests, including a complete blood count or CBC, may also be done to check for evidence of infection.

Long Term Effects

What are the long-term effects of the disease?

In most cases, there are no long-term effects from strep throat. Complications may occur if a strep infection is not treated, including the following:
  • ear infections, such as acute otitis media
  • tonsillitis, with abscesses or damage to the tonsils
  • scarlet fever, a rash associated with strep throat
  • rheumatic fever, an inflammation of the joints and the heart that can cause heart damage
  • poststreptococcal glomerulonephritis, an inflammation of the kidney that can lead to kidney damage
  • very rarely, death

Other Risks

What are the risks to others?

Anyone with an untreated strep throat can spread it to others.

Treatments

What are the treatments for the disease?

Penicillin is the usual treatment for strep throat. If a person is allergic to penicillin, another antibiotic may be used. To prevent the complications of strep infections, it is important to take the entire course of antibiotics prescribed, even if the symptoms subside.
Ways to reduce the symptoms include:
  • rest, especially when fever is present
  • warm salt-water gargles and throat lozenges to reduce pain and inflammation
  • over-the-counter pain medications, such as acetaminophen (i.e., Tylenol), for pain and fever
  • plenty of liquids. Iced drinks or milk shakes, as well as a soft-foods diet, may help to relieve discomfort.
Aspirin should not be given to any person under age 18 without a physicians specific recommendation, as it increases the risk of a serious disorder known as Reye's syndrome.

Side Effects

What are the side effects of the treatments?

The most common side effects of antibiotics are stomach upset, rash, and allergic reaction.

After Treatment

What happens after treatment for the disease?

Most strep throat infections respond rapidly to treatment. Usually no further treatment is needed.

Monitor

How is the disease monitored?

Any new or worsening symptoms should also be reported to the healthcare professional.

Sources

www.niaid.nih.gov/factsheets/strep.htm. www.aafp.org/afp/970100ap/970100a.html.

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