Strep throat is a sore throat that’s caused by infection with Streptococcus bacteria. Symptoms are usually worse than those for viral throat infections. Coughing, sneezing, or a runny or stuffy nose probably means a virus is causing symptoms. People of all ages can have strep throat, but it’s most common from age 5 to 15, and especially during winter. Untreated strep throat can cause complications such as rheumatic fever. Rheumatic fever can lead to painful and inflamed joints, rash, and even heart valve damage.
Strep throat is caused by infection with bacteria named Streptococcus pyogenes, or Group A streptococcus. The infection is very contagious. It spreads by breathing in airborne droplets when someone with the infection coughs or sneezes. Sharing food or drinks, and touching contaminated doorknobs or other surfaces and then the nose or mouth can also pass along the infection.
After infection, symptoms may take 2 to 5 days to start. They include throat pain, swallowing problems, fever (101°F), headache, rash, stomachache, and sometimes vomiting. Loss of appetite, nausea, muscle pain, and joint stiffness can occur. Tonsils can get red and swollen and have white patches or streaks of pus. Tiny red spots can appear on the roof of the mouth. Lymph glands in the neck can be swollen and tender. Not everyone has symptoms, however. Some people are carriers (i.e., those who have the bacteria and can pass it to others but aren’t sick).
Diagnosis is made from symptoms, a physical examination, and laboratory tests. Most important is finding out which bacteria are causing the illness. Throat culture, a rapid antigen test, and a rapid DNA test can help with this.
Treatment involves antibiotics, which shorten the time people are contagious. Penicillin V, taken by mouth, is the treatment of choice. Children can take the better-tasting amoxicillin suspension. People who are allergic to penicillin can take a cephalosporin such as cephalexin or a macrolide such as erythromycin or azithromycin. Medicines (ibuprofen, acetaminophen) can help throat pain and fever. Young children and teenagers shouldn’t take aspirin because of the risk of developing the dangerous Reye’s syndrome. Getting rest, drinking lots of water, eating soothing foods, gargling with warm salt water, using a humidifier, and avoiding irritants such as cigarette smoke can help people feel better.
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