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About Strep Throat

It's a sign of the season - you wake up in the morning with a raw and itching feeling in your throat. If you are like many people, you may think that your sore throat signals the arrival of the common cold. In fact, it sometimes means something more serious which requires the attention of a doctor.

Nearly one out of four cases of sore throat are due to streptococci bacteria. Commonly known as strep throat, this condition can do more than make you miserable. As the body tries to fight off a strep infection, it can sometimes produce antibodies that attack both the strep bacteria and healthy cells. If left untreated, strep throat can lead to such serious complications as rheumatic fever, toxic shock and other potentially fatal conditions.

Most children get strep throat, but the disease is increasingly common in adults,too. In recent years, adult cases have doubled. Doctors agree that it's vital to diagnose strep throat early and treat it thoroughly.

Symptoms

Recognizing strep throat from its symptoms is difficult, even for physicians. There is little to set it apart from a viral sore throat or the onset of flu, but it usually appears without the nasal congestion and runny nose common to colds. Often the first sign is a sore throat that progresses to swollen glands, headache, a persisting fever over 101 degrees Fahrenheit, nausea and abdominal pain. The symptoms may be intense or hardly noticeable, making the diagnosis even more difficult.

Diagnosis

A physician can check the throat for redness, white patches and pus. But the only definitive test for strep is a throat culture, in which the physician rubs the lining of the throat with a cotton swab and tests the sample overnight for presence of strep bacteria.

While this test is the most reliable, there is also a rapid test that can deliver results in ten minutes. To be on the safe side, children who get negative results on the rapid test are usually given overnight throat cultures as well.

Treatment

Once an infection is confirmed, strep is usually treated with a ten-day course of penicillin. Children who can't keep down oral medicine may receive a long-acting injection. Patient allergic to penicillin can take antibiotic substitutes such as erythromycin. Sometimes a combination of antibiotics may be needed to stop a persistent infection.

Treatment can make you feel better in a day. However, it is important to finish all the medication to prevent any recurrence of infection. It is also important to limit your exposure to others for 24 hours after you begin medication, since strep bacteria are highly contagious and can be passed by hands touching the nose or mouth. Children should be kept home from school or day care during this period.

There are about a dozen different groups of strep bacteria. Treatment for one type will not insure immunity against others.

Risks

The risk of incurring a more dangerous strep disease is low. But if it happens, the results can be quite serious. About three percent of strep infections will lead to rheumatic fever, causing pain that moves from joint to joint, involuntary muscle movements and rash. The greatest danger is permanent damage to the heart valves and, ultimately early heart failure.

To prevent rheumatic fever,children who repeatedly catch strep throat may require long-term penicillin treatment. Group-A strep bacteria have become more virulent since the late 1980's. Some strains have given rise to a potentially fatal illness similar to toxic shock. Rare (but dangerous) complications include pneumonia, blood poisoning and strep tonsillitis.

Don't take chances with strep throat!

If you think you have it, seek prompt diagnosis and treatment.
For more information, contact your primary care physician.

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