Strep Throat (Bacterial): What is Strep Throat. Signs, Risk factors & Treatment

Strep throat is also called as streptococcal pharyngitis.

Introduction to Strep Throat

Strep throat is a bacterial infection in the throat and the tonsils. This is commonly called streptococcal sore throat and is caused by the group A Streptococcus species. In this condition, the throat becomes scratchy and inflamed, resulting in a sore throat. This condition should never be neglected, as it can sometimes lead to kidney inflammation and rheumatic fever.

Strep throat can affect all ages, but usually, it is most commonly seen in children and adolescents. It usually spreads among people through cough, sneeze, and close contact. If anyone in the family is infected with strep throat, then the other members of the family are likely to develop within few days.1

Signs and Symptoms of Strep Throat

Some of the signs and symptoms of strep throat are as follows:2

· Difficulty in swallowing, including saliva

· Pain in the throat

· Tender, swollen lymph nodes in the neck and swollen tonsils

· Small red spots on the soft and hard palate

· Rash

· Headache

· Stomachache and vomiting are seen in children

· Fever lasting for more than 48 hours

· Body aches

· Loss of appetite

Risk Factors for Strep Throat

The following are some of the risk factors for strep throat.

· Smoking

· Excess fatigue

· Dwelling in damp areas

· Crowded conditions

Causes of Strep Throat

Strep throat is caused by Streptococcus pyogenes or group A Streptococcus. This bacterium is highly contagious. Apart from sneezes and coughs, this condition can also spread through kitchen utensils and bathroom objects. Other copathogens that cause strep throat include Branhamella catarrhalis, Bacteroides fragilis, Bacteroides oralis, Bacteroides melaninogenicus, Fusobacterium species, Staphylococcus aureus, Haemophilus influenza, and Peptostreptococcus species.

Diagnosis of Strep Throat

The diagnosis is based on signs and symptoms. A physical examination of the chest and throat should be conducted.3 If strep throat is suspected, then the doctor may suggest laboratory tests like a rapid strep test. In a rapid strep test, a sterile swab is used to obtain the sample from the affected area, and the pathogens are identified. The results are given within 20 min. 

Sometimes when the rapid strep test is not effective, a throat culture may be suggested. Here, the sample is swabbed and cultured or grown in a nutrient medium in the laboratory to identify the bacteria. This may take 24–48 h to obtain accurate results.

Treatment of Strep Throat

Strep throat will subside within 3 to 7 days with or without treatment. However, it should not be neglected, as there is a possibility of the development of rheumatic fever. Antibiotics like penicillin may be suggested and should be taken for the prescribed period and never discontinued.4

Discontinuing the medication leads to the return of strep infection. Sometimes, penicillin may not prove effective in some people; in such cases, other antibiotics like amoxicillin, clindamycin, cephalosporin, or erythromycin may be suggested. Antibiotics reduce the contagious period and prevent the infection from spreading to other parts of the body. Acetaminophen or ibuprofen may be suggested for fever and pain.

In case the virus is responsible for strep throat, then antipyretics or analgesics may be taken. Care should be taken to keep oneself hydrated with sufficient amount of liquids, or I.V. fluids may be suggested.5

Early treatment is necessary to prevent the spread of the infection, prevention of rheumatic fever, shorten the symptoms, and fast recovery. 

Prevention of Strep Throat

Strep throat cannot be prevented, but the risk of being affected can always be reduced by the following:6

· Avoiding contact with persons who have a strep throat infection

· Washing hands after food, blowing nose or sneezing

· Proper disposal of tissues

· Avoid sharing of glasses, plates, and toothbrushes

· Do not smoke

· Stay away from work until the infection subsides

 References

1. American Academy of Pediatrics. Group A streptococcal infections. Red Book: Report of the Committee on Infectious Diseases. 2003; 26th edn, pp. 573–585. 

2. Stevens DL. Streptococcal infections. In: L Goldman, D Ausiello (eds). Cecil Textbook of Medicine. 2004; 22nd edn, vol. 2, chap. 308, pp. 1782–1787. 

3. Bisno AL, Gerber MA, Gwaltney JM Jr, Kaplan EL, Schwartz RH. Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Clin Infect Dis. 2002; 35(2): 113–125.

4. Krober MS, Weir MR, Themelis NJ. Optimal dosing interval for penicillin treatment of streptococcal pharyngitis. Clin Pediatr (Phila). 1990; 29(11): 646–648. 

5. Pichichero ME. Controversies in the treatment of streptococcal pharyngitis. Am Fam Physician. 1990; 42(6): 1567–1576.

6. McIsaac WJ, Kellner JD, Aufricht P, Vanjaka A, Low DE. Empirical validation of guidelines for the management of pharyngitis in children and adults. JAMA. 2004; 291(13): 1587–1595.