Strep Throat

 Strep Throat

By Peter Galvin, MD

Strep throat is an infection of the throat caused by Streptococcus pyogenes bacteria (Group A Streptococcus). It is a highly contagious infection spread by respiratory droplets and also through contact with objects such as utensils, plates, cups, and food shared with an infected person. Outbreaks are common in households, schools, and other places with close human contact. These infections are most commonly seen in winter and spring. Strep throat can affect adults but is most commonly seen in children aged 5 to 15 years, sometimes as young as 3 years old.

Common signs of strep throat include sore throat, pain with swallowing (odynophagia), fever (typically 100.4 oF or higher), enlarged tonsils (which may have yellow or white spots), red spots on the roof of the mouth, and a skin rash that feels rough, like sandpaper. Strep throat usually does not cause a cough or runny nose. It can be diagnosed with a throat swab which can either be sent to a lab for culture, or more commonly tested in a rapid strep test which takes about 10 minutes. Throat culture (to detect S pyogenes) is more accurate than a rapid strep test but takes at least 48 hours for results to be available.

Those diagnosed with strep throat should be treated with a 10-day course of antibiotics (typically penicillin V or amoxicillin, unless penicillin allergic). It is important for the patient to take the full 10 days of antibiotics as taking less than the full dosage may cause a relapse or lead to complications. Antibiotics decrease symptoms, shorten the duration of illness, decrease the spread of infection to others, and prevent complications. Complications of untreated or partially treated strep throat can be severe. These complications include tonsillitis, sinusitis, ear infection, pneumonia, and rheumatic fever, which was fairly common before the advent of antibiotics. Rheumatic fever is a potentially serious medical condition that can cause inflammation of the heart and its valves, blood vessels, skin, and joints.

Rarely, people with strep throat develop scarlet fever (aka scarlatina), which presents with a rough, red rash that spreads across the body. The rash usually appears within one to two days after the onset of strep throat symptoms. The rash is a brighter red in the skin folds of the armpits, elbows, and groin. As the rash fades (about seven days after its appearance) the skin may peel. Scarlet fever also causes bumps to appear on the tongue, giving it a “strawberry” appearance. Untreated scarlet fever can lead to acute rheumatic fever and severe kidney and joint conditions.

Of course, every sore throat is not strep throat, but certain symptoms should indicate the need for immediate evaluation and treatment. Those symptoms, when seen in conjunction with a sore throat, include the inability to swallow, eat, or drink, the development of a hoarse voice or change in the voice, difficulty breathing, neck swelling of stiffness, excessive drooling, and a persistent fever.

For more information go to the website of the Centers for Disease Control and Prevention at:          www.cdc.gov

Please direct questions and comments to editor@rockawaytimes.com

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