Strep Throat

Signs, Symptoms, and Treatments

A common bacterial infection, strep throat prompts an estimated 5.2 million Americans  to visit the doctor each year, and results in nearly 3 million antibiotic prescriptions.

In addition to being incredibly painful, untreated strep can lead to serious complications including pneumonia, meningitis, kidney inflammation, infections of the ear and sinuses, rheumatic fever, and more. Which is why it’s important to act promptly when you suspect strep.

While anyone can get strep, it’s most common in school-aged children 5-15 years of age.

Spread by direct contact and respiratory droplets that an infected person puts into the air when they cough, talk or sneeze, strep is considered VERY contagious.  It can spread quickly in a variety of close-proximity settings including daycares, schools, afterschool programs, and workplaces where people work side-by-side. Strep throat typically develops 2 to 5 days after exposure to the bacteria. 

While symptoms can vary, common signs include:

• Sudden, severe sore throat pain

• Difficulty swallowing

• A fever up to 100.4°F

• Swollen lymph nodes on the front of your neck.

• Tonsil Changes, including red, swollen tonsils, possibly with white or yellow spots

• Red Spots on the roof of the mouth 

Other potential symptoms may include fatigue, headache, stomachache and sometimes vomiting, especially in younger children. In some cases, a rash may appear on the neck, armpit, or groin.

It's important to note that strep throat typically does not cause coughing or a runny nose. These symptoms are more common with a viral infection than a bacterial strep infection.

Fortunately, diagnosing and treating strep is relatively easy.

DIAGNOSIS

Strep is diagnosed using one of two tests: rapid strep test or a throat culture.

Both tests involve taking a swab of the throat. While a rapid test offers quick results—about 15 minutes—it’s not as comprehensive as a throat culture, which may take 24 hours to analyze. In fact, if a rapid test is negative but a patient’s symptoms suggest a strep, very often a throat culture will be ordered to confirm the results.

TREATMENT

The standard treatment for strep is antibiotics, typically penicillin or amoxicillin. Patients typically start to feel better in one to two days after taking their first dose. It is very important to complete the full course of antibiotics even if the patient starts to feel better.

People with strep throat should stay home and isolate until their fever has subsided AND they’ve taken antibiotics for at least 24 hours to prevent infecting others. In addition, you should replace your toothbrush after taking antibiotic for 24 hours.

If your symptoms don't improve or get worse after 24-48 hours of antibiotic treatment or you develop new symptoms, such as swelling in the neck or face, difficulty swallowing even saliva, or trouble opening your mouth, contact your doctor immediately.

 Kristin Andrew, FNP-BC, is a member of the care team at Southwestern Vermont Medical Center Pediatrics.