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(Bacterial Sore Throat)

Definition

Strep throat is an infection of the throat and tonsils. It causes pain, redness, or pus in the back of the throat.

Sore Throat Due to Inflammation
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Causes

Strep throat is caused by streptococcal (strep) bacteria. The strep bacteria is spread by airborne droplets. This occurs with coughing or sneezing from infected people, or by touching a contaminated surface and then touching your eyes, nose, or mouth. The droplets can also be inhaled.

Risk Factors

Strep throat is more common in children and adolescents. Other factors that increase your chance of strep throat include:

  • Exposure to family member or friend who has strep throat
  • Crowded living situations
  • Having strep living in the throat—occurs in a large segment of the population

Symptoms

Strep throat may cause:

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

Complications of untreated strep throat can be serious and include:

Post-streptococcal glomerulonephritis (kidney damage) is also rare, but it can occur, even with treatment

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. The doctor may assume strep throat based on symptoms. Tests may be done to confirm. Tests may include:

  • Rapid antigen strep screen—fast test that may not detect all strep throat.
  • Throat culture—A sample of throat fluid is taken to a lab. It takes a few days to gets results.
  • Rapid DNA test—results are usually available in 1 day. Can tell the difference between strep and other throat infections.

Treatment

Most sore throats, including strep throat, will get better in 7 to 10 days. Although the sore throat disappears, the infection may remain. It is important to follow through with proper treatment to prevent serious complications.

Medications

Antibiotics will be given to treat the infection. They may be given as a pill or a shot. Symptoms will often fade in the first few days of treatment. It is important to take all of the antibiotics as prescribed.

Over-the-counter pain relievers and fever reducers may also help.

Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.

Prevention

To help reduce your chances of strep throat:

  • Wash your hands carefully and often.
  • Do not share beverages or food.
  • Avoid exposure to other people who may have a strep infection.
  • Replace your toothbrush after starting antibiotic treatment to prevent re-infecting yourself.

RESOURCES

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

Family Doctor—American Academy of Family Physicians  https://familydoctor.org 

CANADIAN RESOURCES

About Kids Health—The Hospital for Sick Children  http://www.aboutkidshealth.ca 

Health Canada  https://www.canada.ca 

References

Choby BA. Diagnosis and treatment of streptococcal pharyngitis. Am Fam Physician. 2009;79(5):383-390.

Montagnani F, Stolzuoli L, et al. Erythromycin resistance in Streptococcus pyogenes and macrolide consumption in a central Italian region. Infection. 2009;37(4):353-357.

Sore throat. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/ear,-nose,-and-throat-disorders/approach-to-the-patient-with-nasal-and-pharyngeal-symptoms/sore-throat. Accessed January 29, 2021.

Sore throats. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/content/sore-throats. Accessed January 29, 2021.

Streptococcal pharyngitis. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T115782/Streptococcal-pharyngitis. Accessed January 29, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Shawna Grubb, RN
  • Review Date: 01/2021
  • Update Date: 01/29/2021