Strep throat facts
What is strep throat and what causes strep throat?
Strep throat is a bacterial infection of the soft palate and tonsillar region. Microbiologists identify the member of the Streptococcus bacterial family that causes strep throat as "GAS" (Group A, beta hemolytic, Streptococcus pyogenes). Strep throat is most common in young children and adolescents, but it is not unusual in toddlers and adults. It is highly contagious and it is present most commonly in the community during the winter months. Interestingly, the symptoms and physical signs may vary depending upon the age of the infected patient.
What are the signs and symptoms of strep throat?
Signs of strep throat are not unique - indeed many viral infections (which cause the large majority of sore throats) can have identical signs and symptoms as a GAS infection. Typically, an older child and adolescent will have several core symptoms such as:
Of note is that runny nose, cough, hoarse voice, muscle aches, diarrhea and oral blisters are generally not seen with a strep throat infection. These latter symptoms are more commonly indicative of a sore throat caused by a virus.
Signs of strep throat infection include:
The presence of a strep infection and this specific rash is termed scarlet fever. Such a diagnosis does not imply a more severe GAS infection or imply any change in prognosis or management. The rash is not contagious. It is important to note that while most patients with strep throat will experience these signs and symptoms, not all will necessarily be present in each individual.
Are the signs and symptoms of strep throat different in various age groups?
The information listed above is seen in those most likely to have a strep throat infection - individuals that are older children and teenagers. However, other age groups may experience a different constellation of findings with a strep throat infection.
Is strep throat contagious?
Strep throat is moderately contagious and is most commonly spread via direct person-to-person contact. Passage of airborne droplets and/or saliva from the infected individual to another is the most likely mechanism of contracting strep throat. As such, close living quarters (home, classroom, day care centers, college dorms, etc.) provide an ideal environment for passage of GAS bacteria from one person to another. The risk of contracting a strep throat infection is approximately 40% in household environments. Most infectious disease specialists believe that a patient is no longer contagious after 24 hours of effective antibiotic therapy. Spread of strep bacteria via food borne transmission is less common than direct person-to-person exchange of droplets or saliva. The exact likelihood of developing strep throat from family pets is unknown, but most experts believe it is minimal.
How is strep throat diagnosed?
There are two common tests used to establish whether an individual with symptoms of strep throat infection has a strep throat. The traditional test, a throat culture, involves the doctor obtaining a swab from the back of the throat and tonsils. It takes approximately 36 to 48 hours to determine the presence or absence of the GAS bacteria. This test is considered the "gold standard" in diagnosing strep throat.
Many medical offices, clinics and hospital emergency departments use a rapid strep test (RADT - rapid antigen detection test) in an effort to provide a more timely diagnosis for their patients. The throat swab is obtained similarly to that for a traditional throat culture, but a RADT "kit" is employed to help determine the presence or absence of the strep bacteria. The turn around time is generally 10 minutes. The RADT is less precise when compared with a throat culture. Most RADT tests are about 95% accurate in determining the presence of strep bacteria. Most guidelines recommend that a negative rapid strep test be confirmed with a throat culture. Of note, antibiotic pretreatment prior to obtaining a throat swab for strep bacteria can interfere with throat culture results, and thus the ability to correctly diagnose and treat a strep throat infection. Antibiotic treatment prior to a rapid strep test is less likely to have a false negative result since the test is designed to document the presence or absence of the GAS bacteria. Residual dead bacteria in the patient may allow a positive result.
The above tests are designed to determine whether an individual currently has a strep throat infection. Sometimes it may be necessary to determine whether a patient has had a recent history of a strep infection. In that case, two blood tests are available: (a) an ASO (anti streptolysin O) titer, and/or (b) an anti DNase titer. The antibodies that these tests are sensitive to are not commonly present until a few weeks following an acute strep infection. These tests may be ordered when evaluating a patient who may have developed delayed complications (such as rheumatic fever or glomerulonephritis) after a strep throat infection.
What is the treatment for strep throat?
Treatment of a strep throat infection includes the use of antibiotics and over-the-counter medications and home remedies for the reduction of symptoms.
What are home remedies for strep throat?
There are a number of home remedies that may be used for symptom reduction. They may be used whether the patient has strep throat or a viral cause of their illness. These remedies should not be used in lieu of a complete course of antibiotics if a GAS infection is being treated. Home therapies include:
What over-the-counter) OTC drugs are helpful reducing strep throat symptoms?
Several over-the-counter (OTC) medications, such as acetaminophen (Tylenol) and ibuprofen (Advil and Motrin), can be used to lower the fever and provide pain relief for the sore throat. Aspirin should not be used in children or adolescents because of its association with Reye's syndrome.
What antibiotics are prescribed to treat strep throat?
What are the potential complications of strep throat?
The possible complications of strep throat include:
Acute rheumatic fever (ARF): While rare, this complication of an untreated or inadequately treated strep infection can have devastating and lifelong consequences. It is believed that due to incomplete eradication of the strep bacteria, certain GAS cause an immune response which may attack the joints leading to permanent arthritis. More concerning is the autoimmune response to the heart valves which may damage them and may result in heart failure. Many studies have shown that effective and appropriate antibiotic therapy for strep throat vastly reduces the likelihood of developing ARF.
Glomerulonephritis: Similar to the aberration of the immune response seen with ARF, autoantibodies may develop to the microscopic filters (glomeruli) of the kidney. This complication more commonly affects children between 7 to 10 years of age. While more common than acute rheumatic fever, glomerulonephritis carries a less ominous prognosis. Helpful therapies exist and most children make a complete recovery and do not experience long-term kidney damage. Unlike ARF, the development of glomerulonephritis is not necessarily prevented by effective antibiotic treatment.
PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep): Specialists debate the proposed link of a GAS infection in children with the development and/or worsening of obsessive-compulsive behaviors or tic disorder (Tourette's syndrome in the extreme). One area being researched in this controversial condition is whether antibiotic therapy affects the development of or severity of the disorder.
What are the signs and symptoms of strep throat?
Signs of strep throat are not unique - indeed many viral infections (which cause the large majority of sore throats) can have identical signs and symptoms as a GAS infection. Typically, an older child and adolescent will have several core symptoms such as:
Of note is that runny nose, cough, hoarse voice, muscle aches, diarrhea and oral blisters are generally not seen with a strep throat infection. These latter symptoms are more commonly indicative of a sore throat caused by a virus.
Signs of strep throat infection include:
The presence of a strep infection and this specific rash is termed scarlet fever. Such a diagnosis does not imply a more severe GAS infection or imply any change in prognosis or management. The rash is not contagious. It is important to note that while most patients with strep throat will experience these signs and symptoms, not all will necessarily be present in each individual.
Are the signs and symptoms of strep throat different in various age groups?
The information listed above is seen in those most likely to have a strep throat infection - individuals that are older children and teenagers. However, other age groups may experience a different constellation of findings with a strep throat infection.
Is strep throat contagious?
Strep throat is moderately contagious and is most commonly spread via direct person-to-person contact. Passage of airborne droplets and/or saliva from the infected individual to another is the most likely mechanism of contracting strep throat. As such, close living quarters (home, classroom, day care centers, college dorms, etc.) provide an ideal environment for passage of GAS bacteria from one person to another. The risk of contracting a strep throat infection is approximately 40% in household environments. Most infectious disease specialists believe that a patient is no longer contagious after 24 hours of effective antibiotic therapy. Spread of strep bacteria via food borne transmission is less common than direct person-to-person exchange of droplets or saliva. The exact likelihood of developing strep throat from family pets is unknown, but most experts believe it is minimal.
How is strep throat diagnosed?
There are two common tests used to establish whether an individual with symptoms of strep throat infection has a strep throat. The traditional test, a throat culture, involves the doctor obtaining a swab from the back of the throat and tonsils. It takes approximately 36 to 48 hours to determine the presence or absence of the GAS bacteria. This test is considered the "gold standard" in diagnosing strep throat.
Many medical offices, clinics and hospital emergency departments use a rapid strep test (RADT - rapid antigen detection test) in an effort to provide a more timely diagnosis for their patients. The throat swab is obtained similarly to that for a traditional throat culture, but a RADT "kit" is employed to help determine the presence or absence of the strep bacteria. The turn around time is generally 10 minutes. The RADT is less precise when compared with a throat culture. Most RADT tests are about 95% accurate in determining the presence of strep bacteria. Most guidelines recommend that a negative rapid strep test be confirmed with a throat culture. Of note, antibiotic pretreatment prior to obtaining a throat swab for strep bacteria can interfere with throat culture results, and thus the ability to correctly diagnose and treat a strep throat infection. Antibiotic treatment prior to a rapid strep test is less likely to have a false negative result since the test is designed to document the presence or absence of the GAS bacteria. Residual dead bacteria in the patient may allow a positive result.
The above tests are designed to determine whether an individual currently has a strep throat infection. Sometimes it may be necessary to determine whether a patient has had a recent history of a strep infection. In that case, two blood tests are available: (a) an ASO (anti streptolysin O) titer, and/or (b) an anti DNase titer. The antibodies that these tests are sensitive to are not commonly present until a few weeks following an acute strep infection. These tests may be ordered when evaluating a patient who may have developed delayed complications (such as rheumatic fever or glomerulonephritis) after a strep throat infection.
What is the treatment for strep throat?
Treatment of a strep throat infection includes the use of antibiotics and over-the-counter medications and home remedies for the reduction of symptoms.
What are home remedies for strep throat?
There are a number of home remedies that may be used for symptom reduction. They may be used whether the patient has strep throat or a viral cause of their illness. These remedies should not be used in lieu of a complete course of antibiotics if a GAS infection is being treated. Home therapies include:
What over-the-counter) OTC drugs are helpful reducing strep throat symptoms?
Several over-the-counter (OTC) medications, such as acetaminophen (Tylenol) and ibuprofen (Advil and Motrin), can be used to lower the fever and provide pain relief for the sore throat. Aspirin should not be used in children or adolescents because of its association with Reye's syndrome.
What antibiotics are prescribed to treat strep throat?
What are the potential complications of strep throat?
The possible complications of strep throat include:
Acute rheumatic fever (ARF): While rare, this complication of an untreated or inadequately treated strep infection can have devastating and lifelong consequences. It is believed that due to incomplete eradication of the strep bacteria, certain GAS cause an immune response which may attack the joints leading to permanent arthritis. More concerning is the autoimmune response to the heart valves which may damage them and may result in heart failure. Many studies have shown that effective and appropriate antibiotic therapy for strep throat vastly reduces the likelihood of developing ARF.
Glomerulonephritis: Similar to the aberration of the immune response seen with ARF, autoantibodies may develop to the microscopic filters (glomeruli) of the kidney. This complication more commonly affects children between 7 to 10 years of age. While more common than acute rheumatic fever, glomerulonephritis carries a less ominous prognosis. Helpful therapies exist and most children make a complete recovery and do not experience long-term kidney damage. Unlike ARF, the development of glomerulonephritis is not necessarily prevented by effective antibiotic treatment.
PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep): Specialists debate the proposed link of a GAS infection in children with the development and/or worsening of obsessive-compulsive behaviors or tic disorder (Tourette's syndrome in the extreme). One area being researched in this controversial condition is whether antibiotic therapy affects the development of or severity of the disorder.
Source: http://www.rxlist.com
Source: http://www.rxlist.com
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