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Strep Throat by Editorial Staff and Contributors

En Español (Spanish Version)

Definition

Strep throat is a bacterial throat infection.

Sore Throat Due to Inflammation

Causes

Strep throat is caused by the bacterium Streptococcus pyogenes . It is spread by airborne droplets, most often from:

Coughing and sneezing of people who have strep throat
Touching a contaminated surface and then touching your eyes, nose, or mouth

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

Risk factors for strep throat include:

Age: school-aged children
Family member or friend who has strep throat

Symptoms

Symptoms of strep throat include:

Red, sore throat with white patches
Painful, difficult swallowing
Chills
Headache
Swollen, sore glands in the neck
Fever
Nausea and possibly vomiting
Decreased appetite
Rash
Muscle aches, especially in the neck, and abdominal pains, especially in younger children
Fatigue

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests to detect strep throat may be used and include:

Throat culture—Sample of throat secretions is cultured in the laboratory. It takes a few days to gets results.
Rapid antigen strep screen—The results are available in minutes. The test is based on detection of antigens; however, a negative test does not exclude the diagnosis of strep throat.
Rapid DNA test—Using DNA technology to detect strep throat, this test is as accurate as throat culture. The results are usually available in one day.

While only a, rapid DNA test or throat culture can confidently distinguish strep throats from those caused by virus infection, doctors will make a diagnosis and decide about treatment primarily by careful evaluation of symptoms and physical findings.

Treatment

Antibiotic Medications

Almost all sore throats—including strep—will get better on their own in 7-10 days. Strep throat improves more rapidly with antibiotics than without. (Antibiotics do not affect the healing of sore throats due to virus infection.) Given as a pill or a shot, types of antibiotics include penicillin, amoxicillin , erythromycin , azithromycin , or cephalosporin antibiotics. Symptoms begin to disappear after only a few doses, but it is crucial that you finish the entire prescription.

Serious complications of undertreated strep throat include:

Kidney damage ( glomerulonephritis )
Scarlet fever
Rheumatic fever
Tonsillitis or peritonsillar abscess
Ear or sinus infection

Antibiotics are typically given to prevent the complication of rheumatic fever from occurring after strep throat infection. In many communities, neither azithromycin nor erythromycin are reliably effective in treating strep throat or preventing rheumatic fever due to resistance of the bacteria.

Over-the-Counter Pain Medications

Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help relieve sore throat and muscle aches and pains.

Note : Aspirin is not recommended for children or teens with a current or recent viral infection. This is because of the risk of Reye's syndrome . Ask your doctor which other medicines are safe for your child.

If your are diagnosed with strep throat, follow your doctor's instructions .

Prevention

To reduce your chances of getting strep throat:

Wash your hands carefully.
Don't share beverages or food.

RESOURCES:

American Academy of Otolaryngology—Head and Neck Surgery http://www.entnet.org
Familydoctor.org http://familydoctor.org

CANADIAN RESOURCES:

About Kids Health http://www.aboutkidshealth.ca
Health Canada http://www.hc-sc.gc.ca

References:

American Academy of Otolaryngology–Head and Neck Surgery website. Available at: http://www.entnet.org . Accessed October 12, 2005.
Cecil RL, Goldman L, Bennett JC. Cecil Textbook of Medicine . 21st ed. Philadelphia, PA: WB Saunders Company; 2000.
Ebell MH, Smith MA, Barry HC, Ives K, Carey M. Does the patient have strep throat? JAMA . 2000; 284:2912-2918.
Montagnani F, Stolzuoli L, Croci L, et al.Erythromycin resistance in Streptococcus pyogenes and macrolide consumption in a central Italian region. Infection . 2009 Aug;37(4):353-357.
Neuner JM, Hamel MB, Phillips RS, Bona K, Aronson MD. Diagnosis and management of adults with pharyngitis. A cost effectiveness study. Ann Intern Med . 2003;139:113-122.
Ressel G. Practice guidelines: principles of appropriate antibiotic use: part IV: acute pharyngitis. Am Fam Physician . 2001;64(5).
Strep throat. JAMA . 2000 Dec 13.
Strep throat. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/strep-throat/DS00260 . Accessed November 10, 2007.
Streptococcal pharyngitis. DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Accessed November 10, 2007.

Last reviewed September 2012 by Brian Randall, MD

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