Strep Throat
(Throat Infection · Strep · Streptococcal Pharyngitis)
In this condition factsheet:
The Facts on Strep Throat
Strep throat is a common bacterial infection, accounting for about 15% of all sore throats that get diagnosed in the doctor's office.
It's called "strep" throat because the bacterium that causes it belongs to the class known as group A streptococcus (GAS). Although strep throat can occur any time during the year, late winter and early spring are considered to be peak seasons for strep throat infections.
Sore throat is one of the leading complaints that bring people to the doctor's office, and the majority of adults with sore throats are treated with antibiotics, though fewer than half of the people given antibiotics actually have bacterial infections. Most of the rest have viral infections that are not affected by antibiotics.
When used appropriately, antibiotics are very helpful in fighting infection. However, antibiotics used inappropriately can be bad for you, killing harmless bacteria that may be keeping dangerous bacteria out of your intestines. It is important to learn about appropriate (and unnecessary) antibiotic use, which includes not pressing a doctor for antibiotics when the doctor says they aren't needed.
Causes of Strep Throat
Streptococci are everywhere – many people carry it on their skin and throat. They don't always cause disease: that is, they don't always cause strep throat infection. However, streptococci are infectious. They are passed around in the same way as cold viruses, by coughing, sneezing, or getting mucus or saliva on the hand, then touching other people. They are less contagious than a cold virus, however.
Symptoms and Complications of Strep Throat
Streptococcal pharyngitis, as strep throat is formally known, causes these symptoms:
- fever (greater than 38°C or 100.4°F), chills, and sweating
- headache
- nausea and vomiting (sometimes)
- sore throat
- swollen tonsils and lymph nodes in the neck
- white patches on the tonsils
Coughing, runny nose, stuffiness, and sneezing aren't associated with strep throat and are usually signs of a viral infection. It's also rare for streptococcus to invade the larynx (voice box), causing hoarseness – this is far more likely with a virus. Of course, it's possible to have both viral and bacterial infections at the same time.
After exposure, it takes about 24 to 72 hours for the bacteria to incubate in the body, or become great enough in number before symptoms are seen.
Before the discovery of antibiotics, strep throat often led to serious complications. The most dangerous of these was rheumatic fever. In rheumatic fever, the immune system inflicts serious damage on the vital heart valves. This can leave a person vulnerable to a certain type of heart problem later in life. Fortunately, this is a very rare occurrence today.
Other possible complications include immune overreaction in the joints (arthritis) or in the kidneys (glomerulonephritis). The bacteria can also travel up tubes that link the throat to the middle ears (the eustachian tubes). This is especially likely in young children, whose ear tubes aren't yet fully developed. This causes otitis media, which is an infection of the middle ear. The bacteria may also get into the lining of the brain and cause meningitis.
All of these complications are extremely rare, except otitis media. A few children develop a chronic pattern of recurring throat and ear infections.
The syndrome known as scarlet fever is a fairly rare, usually mild complication of strep throat, and is essentially nothing more than strep throat accompanied by a temporary red rash. The rash is most prominent on the abdomen and the sides of the chest. Some skin may peel when it subsides.
If complications do appear, they often come 1 to 6 weeks after the strep throat infection. Call a doctor if you see any of these symptoms:
- earache
- joint pain
- nosebleeds
- severe abdominal pain
- stiff neck
- sudden high fever
