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Strep Throat symptoms, causes, and treatment – Streptococcus pyogenes.

Strep throat is a common infection that affects children and adults. In the following article, you’ll find out everything you need to know.

This reading is designed for you to learn everything you need about strep throat. This is why we gathered the most frequently asked questions about this condition. Also, we’ll have them answered in simple words, directly by a doctor. This way, you can acquire the necessary knowledge about this condition that affects so many people annually.

What is the pharynx? 

The pharynx is an anatomical structure located in the neck. We commonly call it the “throat.” It has a cone shape and connects the oral and nasal cavities to the esophagus and the larynx. Muscle fibers and connective tissue constitute it, and it’s attached to the base of the skull.

File:2303 Anatomy of Nose-Pharynx-Mouth-Larynx.jpg
Source

With these latter muscles, the pharynx performs functions of swallowing and many others. It has both respiratory and digestive functions. The pharynx is divided into 3 portions: the nasal pharynx, the oral pharynx, and the laryngeal pharynx. Each one of them has different functions and contains different structures.

The first portion is the nasal pharynx, which connects the nasal cavities to the oral pharynx. The second portion begins at the back of the mouth and continues down to the epiglottis. Here we find the tonsils, masses of lymphatic tissue. This connection between the nasal and oral pharynx is what lets humans breathe through the nose and mouth. The third portion is the laryngeal pharynx. Its function is to regulate the passage of air to the lungs and food to the esophagus. 

What is strep throat? 

Strep throat is a common upper respiratory tract infection. It is also known as streptococcal pharyngitis, and it affects an oral portion of the pharynx. The infection can also affect other structures, like the tonsils, causing tonsillitis. It is the most common form of bacterial infection of the throat. The cause of it is a streptococcal bacteria infection.

The most common species that cause strep throat infection is the Streptococcus pyogenes. It is part of a group of bacteria called Group A Streptococcus or GAS. This is a common bacterium that usually lives in your nose and throat. However, it can sometimes cause infections.

Strep throat infection is more common in children, but it can affect adults too. Streptococcal infection is the most common type of bacterial infection to causes sore throat. This type of infection is so common that around 11 million people get diagnosed with it annually in the US. Also, it’s the cause of approximately 40% of sore throats in children and 15% in adults. 

Is pharyngitis strep throat?

Pharyngitis is not the same as for strep throat. All cases of strep throat are pharyngitis, but not all pharyngitis is strep throat. Pharyngitis simply refers to inflammation of the throat for any reason. Most pharyngitis cases have a viral origin, and only a minority of pharyngitis cases are strep throat.

Is strep throat contagious? 

Yes, strep throat is an infectious disease that is easily transmitted from person to person. Transmission usually occurs via respiratory droplets of nasal or oral secretions.

People with no symptoms (asymptomatic throat infection) due to streptococcus pyogenes are very likely to pass on the infection. You can get infected with strep throat if someone with it coughs over you, if you touch contaminated surfaces and rub your hands against your face, or by sharing food and drinks with an infected person.

After getting infected, it may take two to five days before developing the first symptoms. Still, you might be infectious for a few days, even before the development of symptoms.

What is the cause of strep throat? 

Like we mentioned before, the cause for strep throat is the infection by strep bacterium or Streptococcus pyogenes. This bacterium is part of the genus Streptococcus. This means it has a round shape and organizes itself in chains. Also, the name pyogenes implies that it produces pus when it infects the tissues. Doctors also call it Group A Streptococcus (GAS) because of other specific characteristics.

Around the globe, there are around 700 million GAS infections every year. Of which the majority are strep throat infections. Remember that viral infections are the leading cause of sore throat. Streptococcus bacteria can also cause skin infections. Nevertheless, strep throat is the most common cause of bacterial sore throat. 

Streptococcus bacteria usually live in the nose and the throat. It can readily spread to other people and cause infection. You must know that, sometimes, an infected person won’t show symptoms. So, it’s easier to become infected.

Strep bacteria are spread by respiratory droplets that people produce when they talk, cough, or sneeze. When these droplets get to your eyes, mouth, or nose, you can get the infection too. People can also get sick after touching a contaminated surface and then touching their mouth or nose. Also, you can get sick after drinking the same glass or eating from the same plate or an infected person. 

How do children get it? 

Children get strep throat the same way any other person can get it. However, strep throat is more common in children because their immune system hasn’t matured

Streptococcus bacteria are present in the nose and the throat. This way, it can be spread to other people when an infected person coughs or sneezes. This happens through the tiny droplets we produce when we do any of this. This is when strep bacteria spreads through direct contact.

On the other side, strep bacteria can also spread through indirect contact. This happens when contaminated respiratory droplets fall on surfaces or objects. If you touch any of them, then you can get strep in your mouth or nose. 

It’s more common for children to get this infection for many reasons. First, small children usually don’t have the habit of washing their hands, touching almost everything. Also, they commonly are around many other children that can be infected. This dramatically increases their chance of getting the infection. Besides, small children have an immature immune system. This means they will get sick very often until their immune system is exposed to many different germs. 

What are the risk factors? 

Anyone can get a strep throat infection. Yet, like in any other condition, certain factors make you more likely to have it. The most common risk factor for strep throat include: 

  • Age: Strep throat is more common in children from 5 to 15 years old. It also affects children younger than 5, but sometimes they’ll have different symptoms. Adults can get it too, but children will get more commonly affected by this condition.
  • Close contact: This includes schools and daycare centers. When there are many people in the same space, the chances of getting the infection increase, this also applies to people who live with potentially infected people. 
  • Poor hygiene: Hand washing is a significant way to prevent strep throat and many other infections. A person can get the strep bacterium in their hands and then touch their nose or mouth. This can result in them getting infected. This is also a reason why children are more commonly affected by strep throat. A kid usually will cough or sneeze into their hands or touch their nose without a tissue. If you don’t practice minimal hygiene measures, you’ll probably get sick.
  • Being exposed to irritants, like air pollution or cigarette smoke. These agents can make your throat irritated. This leaves your throat prone to infection from viruses and bacteria like Streptococcus. 
  • Time of the year: Strep throat, like many other respiratory infections, has a seasonal behavior. Strep throat occurs all year long, but it’s more common during winter and early spring. This also correlates to the time when people spend the most time indoors. It’s also the time when kids go to school and spend time with many other kids. 

What are the symptoms of strep throat? 

Most of the time, strep throat is a mild infection. However, it can be harrowing and uncomfortable. The incubation period may vary. Typically, it takes around 5 days for an infected person to show symptoms. The most common strep throat symptoms include: 

  • Sore throat or throat pain: This is the most common symptom. It can be very intense, to the point where it becomes difficult to eat or drink anything. This symptom can appear suddenly when the infection occurs. 
  • Bright red throat with white patches: The white patches usually contain pus. 
  • Fever: This is another common symptom of infection. Usually, the fever is 101 F or higher in strep throat and can be hard to manage. 
  • Swollen tonsils: Or tonsils with pus or white plaques. This is also known as tonsillitis. 
  • Swollen lymph nodes: This happens because lymph nodes are tissue that helps you fight infections. This is where most of your immune system gets to work. In the case of strep throat, the lymph nodes affected are the ones in the neck. You can also feel tenderness or mild pain. 

Patients can also experience symptoms like chills, loss of appetite, and trouble swallowing due to sore throat. Other symptoms like runny nose and other cold symptoms are not expected. If these symptoms are present, it may indicate a viral infection instead of strep throat. 

Do you cough with strep?

Yes, it is possible to cough with strep throat, although it is more common for viral sore throat. Then, strep bacteria in your throat can come out in the respiratory droplets produced when you cough and are, therefore, infectious to other people.

How long does strep throat last?

Strep throat lasts for five days approximately without treatment; recovery can occur within 2 to 3 days. Without antibiotic treatment, patients remain contagious weeks after symptoms disappear.

What causes tightness in the throat? 

Tightness in the throat is a widespread symptom of this infection. Nevertheless, it can occur in many different conditions and manifest in many different forms. The patient can describe tightness in the throat like a swollen throat, feeling a lump in your throat, a band around your neck, or something blocking your throat. Strep throat is one of the reasons to feel tightness in your throat. However, other common causes include: 

  • Heartburn or GERD (gastroesophageal reflux disease): In this condition, the muscles between the esophagus and stomach don’t contract properly. This causes stomach acid to back up into the esophagus, resulting in heartburn or tight throat feeling.
  • Throat infections: Like strep throat and tonsillitis. These infections cause swollen glands and other symptoms like painful swallowing. 
  • Allergic reactions: If you have a severe allergic reaction, you may feel tightness in your throat and even difficulty breathing. 
  • Anxiety: It’s pretty common for anxiety to cause several physical symptoms. This includes throat tightness, sweating, shaking, and shortness of breath. 
  • Enlarged thyroid gland: The thyroid is a gland with the shape of a butterfly located in the front of your neck. It produces hormones that control your metabolism. Certain conditions affect your thyroid gland, causing it to swell. A swollen thyroid gland can also cause throat tightness. 

What are the possible complications? 

Strep throat is usually a mild condition with an excellent prognosis. However, some complications can happen in untreated strep throat. Luckily, they are not common. Possible complications of strep throat or strep infection include: 

  • Peritonsillar abscess: Or simply collections of pus around the tonsils. This is the result of a bacterial infection, particularly when you left a strep infection go untreated. For treatment, you may need IV antibiotics or even surgery to drain the pus. 
  • Necrotizing fasciitis: This happens mostly in skin infections. When this infection goes untreated, the bacteria can affect deeper tissues like fascia. The fascia is the tissue that covers the muscles. This can be a very serious complication if not treated on time. 
  • Acute rheumatic fever: It occurs when the strep bacterium gets to your bloodstream. It mostly affects the heart. Thankfully, it’s not that common. 
  • Post-streptococcal glomerulonephritis: In simple words, kidney disease. It occurs because of an immune system reaction that ultimately damages kidneys instead when attacking the strep toxins.
  • Other infections: Like sinus infections or ear infections

What is rheumatic fever? 

Rheumatic fever is an autoimmune inflammatory reaction that occurs 2 to 4 weeks after an episode of strep throat or other streptococcus pyogenes infections such as cellulitis or erysipelas. In rheumatic fever, your immune system mistakenly recognizes the body’s tissue proteins as streptococcus pyogenes antigens, thus leading to a destructive inflammatory response.

What are the symptoms of rheumatic fever?

Rheumatic fever attacks the joints, the heart, the central nervous system, the skin, and the soft tissue under it. Here is a list of the main symptoms.

Arthritis

It means joint inflammation. In rheumatic fever, arthritis is polyarticular and migratory. This means that it often attacks multiple joints but moves from one joint to another. It usually involves large joints, such as the knees, elbows, and ankles. In the majority of cases, joint inflammation resolves after 4 to 6 weeks without leaving any permanent damage.  

Erythema marginatum

It is a red, painless eruption that involves the upper part of the trunk; it is usually very mild and is only noticeable in fair-skinned individuals. The lesion can go on and off for weeks or months.

Sydenham chorea

It consists of jerky, uncontrollable movements of the face, hands, and feet. Episodes are usually sporadic, but in severe cases, they can be quite frequently. They can become a real problem for both the patient and their family. It usually starts 1 to 6 months after a strep throat episode; it can continue for months and even years.

Subcutaneous nodules

These are small, painless nodules or lumps underneath the skin. The patient rarely notices them, but an experienced physician can see them for a physical medical exam.

Carditis

It is the most serious complication of rheumatic fever due to streptococcal infection. Rheumatic carditis permanently damages the heart valves that separate the four heart chambers. This valve damage can lead to congestive heart failure, which is a life-threatening condition. Common symptoms include shortness of breath, swelling of the lower extremities, and chest pain. Sometimes the patient does not has any symptoms at first.

What is post-streptococcal glomerulonephritis?

In post-streptococcal glomerulonephritis, the immune complexes between antibodies and streptococcal antigens deposit in the renal glomerulus, causing inflammation and damage in that area. Kidney damage leads to a medical syndrome called a nephritic syndrome. Nephritic syndrome has three main symptoms.

Blood in the urine (hematuria)

It can be macroscopic hematuria, easily noticeable while urinating (the urine turns brown or reddish), or microscopic hematuria. There isn’t enough blood in the urine to produce a color change. A urinalysis is the best method to diagnose microscopic hematuria.

Hypertension

The kidney is an important organ in arterial pressure regulation; damage to the glomerular apparatus will raise blood pressure, resulting in hypertension or high blood pressure.

Water retention (edema)

When the kidney does not work correctly, water and sodium retention that causes certain body parts to fill up with liquid, thus appearing puffy or swelled up. In nephritic syndrome, edema typically appears in the face, around the eyes. Although, it can also appear in the lower extremities. Facial edema tends to be prominent upon waking and subsides throughout the day.

Besides these three main symptoms, patients can also exhibit other symptoms such as weakness, malaise, abdominal pain, lack of appetite, nausea, and vomiting.

Post-streptococcal glomerulonephritis appears 1 to 2 weeks after a throat infection and 3 to 4 weeks after a skin infection due to streptococcus pyogenes. 

What tests diagnose strep throat? 

In order to diagnose strep throat, you should go to the doctor. Once you get there, the doctor will ask questions about your symptoms and medical history. This will help them get an idea of what can be the problem with you. Then, they will perform a physical examination. For strep throat, this is a crucial part of getting a correct diagnosis.

Your doctor can find common signs of strep infections like swollen throat and white patches by doing this. However, this is not enough to ensure a diagnosis.

Doctors probably need further laboratory tests like a complete blood count (CBC) and a throat swab. A doctor can tell if you have a viral or bacterial infection with a CBC and, being more specific, with white blood cells.

Nowadays, the most common way to diagnose bacterial pharyngitis is through a rapid strep test. Moreover, with a throat swab, they can get a sample of your throat to know what germ is causing the infection. This sample can be cultured to show a bacterial positive test. They let doctors determine pretty quickly if Streptococcus pyogenes cause the infection. 

What tests are helpful in strep throat?

Most of the time, strep throat diagnosis is clinical. This means that, in the majority of cases, physicians make the diagnosis and prescribe treatment based only on the signs and symptoms exhibited by the patient. There are two main kinds of laboratory testing useful in strep throat: 

Rapid antigen detection tests; also called rapid strep test or rapid strep screen.

It is a simple in-office test that detects the presence of streptococcus pyogenes. The doctor will ask you to open your mouth wide and press your tongue down with a wooden tongue depressor. It will then use a cotton swab to take a sample from the back of your throat (throat swab). Although this test is fairly reliable, the use of mouthwash and antibiotics can affect the results, leading to false negatives. Rapid antigen detection tests offer the advantage of providing immediate results.

Throat culture

This exam remains the gold standard for strep throat infection testing because it has a smaller error margin than rapid antigen detection tests. However, while rapid antigen detection tests offer immediate results, cultures take 48 to 72 to grow, which causes a delay in treatment. The sample-taking procedure is very similar to the one in rapid antigen detection tests. Nowadays, throat cultures are only necessary when rapid antigen detection tests turn out negative in a patient with high suspicion of strep throat. 

Imaging studies such as CT scans are not useful in strep throat; however, they might help detect mastoiditis and abscesses complications.

What specialty of doctors treats strep throat? 

Almost any doctor can treat a strep throat infection. Your family physician or your primary care doctor is qualified to diagnose and treat this condition. Nevertheless, if you suffer from recurrent strep throat infections, you may need a specialist. The doctors who specialize in ears, nose, and throat (or ENT doctors) are the ones you should go to. They can give you the proper treatment or even set you for surgery in the event of recurrent tonsillitis. 

What is the treatment for strep throat? 

Since the cause of strep throat is a bacterial infection, the treatment is primarily antibiotics. Most commonly prescribe antibiotics for this condition include amoxicillin and penicillin.

Your doctor will determine the duration of the treatment. However, the average for this type of treatment is around 7 days. You may start to feel better a couple of days after starting your treatment. You should still take it for as long as your doctor tells you to. If you stop, you are at risk of developing the infection again and making the bacteria more resistant to antibiotics. 

What can be done to relieve the pain of strep throat? 

The best thing you can do is to take your antibiotics. It’s the only way to cure the infection. However, you can do a few things to relieve the pain while the antibiotics do their job. Some recommendations to relieve symptoms of strep throat include: 

  • Drinking warm liquids. 
  • Drinking cold beverages to numb the throat. 
  • Taking over-the-counter pain relievers like acetaminophen and ibuprofen. 
  • Sucking on throat lozenges: They have compounds that can numb your throat and relieve the pain. 
  • Doing gargles with salt water: This helps reduce the swelling, and you’ll feel better.

Does apple cider vinegar kill strep throat?

Although some non-scientific publications suggest that apple cider vinegar kills the bacterium responsible for bacterial pharyngitis, there is absolutely no scientific evidence behind this claim.

The only agents known to man that can kill a bacterium are antibiotics. And even if apple cider vinegar could provide some symptomatic relief, it certainly can not prevent any of the disease’s complications.

How can you know if your sore throat needs medical attention? 

You should always get medical attention with a sore throat. This is because you’ll need a doctor to prescribe antibiotics. The big majority of the cases will get better with at-home treatment. Yet, you should get emergency medical attention if: 

  • A severe sore throat. 
  • Having a fever over 101 F degrees that lasts for more than two days.
  • Having trouble breathing or sleeping due to a throat blocked by swollen tonsils. 
  • Experiencing a red rash in your body. 

How can you prevent contracting strep throat? 

Unfortunately, there is no definite way, like a vaccine, to prevent this condition. However, there are a few ways you can lower your chances of getting infected: 

  1. Basic hygiene: By simply washing your hands, we prevent many infections, including strep throat. Wash your hands regularly, especially after touching potentially infected surfaces. 
  2. Avoiding close contact with infected people: It’s also helpful that you avoid places with a lot of people. 
  3. Don’t share drinks or food with anyone: People can be infected or have strep throat before showing symptoms. 
  4. Cover your nose and mouth while sneezing and coughing: This way, you prevent spreading the infection. 

Do you think you have strep throat?

This is a Strep throat Symptoms checker. It gathers the most important signs, symptoms, and risk factors for this disease. Therefore, the tool will tell anybody who uses it if their symptoms are because of strep throat (Streptococcus pyogenes infection). Importantly, using this tool is free and would take a few minutes.

What do you think?

Written by Dr. Esteban Kosak

Doctor of Medicine - MD Recently Graduated from Medical School and inspired to aid the global population during this situation. I think that we shall no longer be waiting to see a doctor when we feel sick. Several times we feel disease searches in Google drive us to a rabbit hole and come out thinking that we may die of cancer or something very serious, given that symptoms may seem to fit a wide variety of illnesses. Since I recently graduated from medical school. I have all the medical information fresh in my mind. My thorough experience as an expert researcher allows me to very-well known the different diseases and conditions that affect human bodies. Empowered by the United Nations 17 Sustainable Development Goals (SGDs). I think that we all can provide a grain of sand to help humanity. That's why we created Symptoms.Care a place where you can come and screen your symptoms and find what different illnesses can be related to them. Armed with the right information you can instantly, discretely, secure and from the comfort of your home talk with a Doctor that can Evaluate your Symptoms and help you seek the right treatment.

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