Strep Throat: A-to-Z Guide from Diagnosis to Treatment to Prevention

Strep Throat

Strep Throat

Related concepts:

Strep pharyngitis, Acute pharyngitis, Exudative pharyngitis

Introduction to strep throat:

Some children fool their parents, with just a fever and a headache or stomachache. Others have the worst sore throat they can remember. Either way, strep throat should be treated with antibiotics.

What is strep throat?

Strep throat is a bacterial infection of the throat. It is the most common infection caused by Streptococcus bacteria. Most sore throats, though, are caused by viral infections that are not improved by antibiotics. There are many strains of strep; some of them produce toxins that can lead to a scarlet fever rash. This rash is thought to be an allergic reaction to these toxins. Untreated, strep throat can sometimes lead to rheumatic fever. Kidney complications are among the other possibilities.

Who gets strep throat?

Strep throat is most common in children between the ages of 5 and 15. It is unusual in children before the third birthday. Children younger than 3 can get strep infections, but usually not primarily of the throat. Strep throat is most common in the late fall, winter, and early spring, perhaps because children are in closer contact with each other during those months.

What are the symptoms of strep throat?

People with strep throat get sick an average of 3 days after they are exposed (range, 2–5 days). Illness usually begins suddenly, with a fever that peaks on the second day. Many children also have sore throat, headache, stomachache, nausea, or chills.

The throat and tonsils are often swollen and beefy red, covered in a gray/white/yellow coat. Red or purple spots may develop on the roof of the mouth. Lymph nodes in the neck may be tender.

In some people, strep throat is very mild, with only a few of these symptoms. In others, strep throat is severe.

How is strep throat diagnosed?

A strep test, along with the appropriate history and physical findings, can assist in the diagnosis. In the absence of the test, strep throat is often confused with other throat infections, including those caused by adenovirus, Mycoplasma bacteria, or Epstein–Barr virus (mononucleosis).

How is strep throat treated?

Antibiotics are used to treat strep throat and to prevent many of its complications, including rheumatic fever. Ibuprofen can help children feel much better while the antibiotic is taking effect. The Centers for Disease Control and Prevention (CDC) recommends against treating sore throats with antibiotics unless the strep test is positive.

How can strep throat be prevented?

Treatment involves avoiding close contact with those who are contagious. Children should be kept out of school or daycare until they have been on antibiotics for 24 hours. Most people are no longer contagious 24 hours after starting the antibiotic. I also recommend getting a new toothbrush for children after they are no longer contagious but before they finish the antibiotics, to prevent re-infection.

Related A-to-Z Information:

Adenovirus, Airborne Transmission, Contact Transmission, Droplet Transmission, Epstein–Bar virus (Mononucleosis, Mono), FomitesScarlet Fever, Streptococcus (Strep)

Reviewed by: Khanh-Van Le-Bucklin, Liat Simkhay Snyder
Last reviewed: November 14, 2013
Dr. Alan Greene

Article written by

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.