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Does strep have a cough: Strep Throat: All You Need to Know


Impetigo: All You Need to Know

Protect Yourself and Others

People can get impetigo more than once. Having impetigo does not protect someone from getting it again in the future. While there is no vaccine to prevent impetigo, there are things people can do to protect themselves and others.

Wound Care

Keep sores caused by impetigo covered in order to help prevent spreading group A strep to others. If you have scabies, treating that infection will also help prevent impetigo.

Good wound care is the best way to prevent bacterial skin infections, including impetigo:

  • Clean all minor cuts and injuries that break the skin (like blisters and scrapes) with soap and water.
  • Clean and cover draining or open wounds with clean, dry bandages until they heal.
  • See a doctor for puncture and other deep or serious wounds.
  • If you have an open wound or active infection, avoid spending time in:
    • Hot tubs
    • Swimming pools
    • Natural bodies of water (e. g., lakes, rivers, oceans)


Appropriate personal hygiene and frequent body and hair washing with soap and clean, running water is important to help prevent impetigo.

The best way to keep from getting or spreading group A strep is to wash your hands often. This is especially important after coughing or sneezing. To prevent group A strep infections, you should:

  • Cover your mouth and nose with a tissue when you cough or sneeze.
  • Put your used tissue in the waste basket.
  • Cough or sneeze into your upper sleeve or elbow, not your hands, if you don’t have a tissue.
  • Wash your hands often with soap and water for at least 20 seconds.
  • Use an alcohol-based hand rub if soap and water are not available.

You should wash the clothes, linens, and towels of anyone who has impetigo every day. These items should not be shared with anyone else. After they have been washed, these items are safe for others to use.


People diagnosed with impetigo can return to work, school, or daycare if they:

  1. Have started antibiotic treatment
  2. Keep all sores on exposed skin covered

Use the prescription exactly as the doctor says to.

Once the sores heal, someone with impetigo is usually not able to spread the bacteria to others.

Post-Streptococcal Glomerulonephritis (PSGN) | CDC

PSGN Is a Rare Complication from a Prior Group A Strep Infection

PSGN is a kidney disease that can develop after infections caused by bacteria called group A Streptococcus (group A strep). These infections include throat and skin infections like strep throat, scarlet fever, and impetigo. PSGN is not a group A strep infection of the kidneys. Instead PSGN results from the body’s immune system fighting off the group A strep throat or skin infection.

It usually takes about 10 days after the start of symptoms of strep throat or scarlet fever for PSGN to develop. It takes about 3 weeks after the start of symptoms of group A strep skin infection for PSGN to develop.

You Cannot Catch PSGN from Someone Else

People cannot catch PSGN from someone else because it is an immune response and not an infection. However, people with a group A strep infection can spread the bacteria to others, primarily through respiratory droplets.

Warning Signs Usually Point to Kidney Issues

Symptoms of PSGN can include:

  • Dark, reddish-brown urine
  • Swelling (edema), especially in the face, around the eyes, and in the hands and feet
  • Decreased need to pee or decreased amount of urine
  • Feeling tired due to low iron levels in the blood (fatigue due to mild anemia)

In addition, someone with PSGN usually has:

  • Protein in the urine
  • High blood pressure (hypertension)

Some people may have no symptoms or symptoms that are so mild that they don’t seek medical help.

Children Most Often Affected

Anyone can get PSGN after recovering from strep throat, scarlet fever, or impetigo. People at increased risk for those infections are also at increased risk for getting PSGN.

PSGN is more common in children than adults. Developing PSGN after strep throat or scarlet fever is most common in young, school-age children. Developing PSGN after impetigo is most common in preschool-age children.

Doctors Look at How Well the Kidneys Are Working

Doctors diagnose PSGN by looking at a patient’s medical history and ordering lab tests. Doctors can test urine samples to look for protein and blood. Doctors can also do a blood test to see how well the kidneys are working. They can also determine if a patient recently had a group A strep infection.

Treatment Focuses on Managing Swelling, Blood Pressure

Treatment of PSGN focuses on managing symptoms as needed:

  • Decreasing swelling (edema) by limiting salt and water intake or by prescribing a medication that increases the flow of urine (diuretic)
  • Managing high blood pressure (hypertension) through blood pressure medication

People with PSGN who may still have group A strep in their throat are often provided antibiotics, preferably penicillin.

Serious Complications Include Long-term Kidney Damage

Most people who develop PSGN recover within a few weeks without any complications. While rare, long-term kidney damage, including kidney failure, can occur. These rare complications are more common in adults than children.

Protect Yourself and Others

The main way to prevent PSGN is to prevent group A strep infections like strep throat, scarlet fever, and impetigo. Getting a group A strep infection does not protect someone from getting it again in the future. There are no vaccines to prevent group A strep. However, there are things people can do to protect themselves and others.

Good Hygiene Helps Prevent Group A Strep Infections

The best way to keep from getting or spreading group A strep is to wash your hands often. This is especially important after coughing or sneezing and before preparing foods or eating. To practice good hygiene, you should:

  • Cover your mouth and nose with a tissue when you cough or sneeze
  • Put your used tissue in the waste basket
  • Cough or sneeze into your upper sleeve or elbow, not your hands, if you don’t have a tissue
  • Wash your hands often with soap and water for at least 20 seconds
  • Use an alcohol-based hand rub if soap and water are not available

You should also wash glasses, utensils, and plates after someone who is sick uses them. These items are safe for others to use once washed.

Antibiotics Help Prevent Spreading the Infection to Others

Prevent spreading group A strep infections to others. People with a group A strep infection should stay home from work, school, or daycare until they:

  • No longer have a fever
  • Have taken antibiotics for at least 12 hours

Take the prescription exactly as the doctor says to. Don’t stop taking the medicine, even if you or your child feel better, unless the doctor says to stop.


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Two Questions May Rule Out Strep Throat – WebMD

By Brenda Goodman

HealthDay Reporter

MONDAY, Nov. 4 (HealthDay News) — Your throat is on fire. It hurts to swallow, and you’re losing your voice. Is it time to see a doctor for antibiotics?

In the near future, researchers report, it may be possible to click on an app, answer two questions about your symptoms and find out whether a seriously sore throat is actually a strep infection.

“Those questions would be: Do you have a cough, and have you had a fever in the last 24 hours?” said study author Dr. Andrew Fine, a pediatric emergency medicine specialist at Boston Children’s Hospital. High fevers are a hallmark of strep infections, while coughs are not.

In a new study of more than 70,000 patients with sore throats, those two questions and an accounting of how common strep infections were within a local area ruled out cases of strep throat nearly as well as lab tests did.

“This enables us to use the test of time,” said co-study author Dr. Kenneth Mandl, a professor of bioinformatics at Harvard. “If we determine that you’re low risk and most cases will not have an important complication from strep anyway, then you can be followed clinically rather than come in for a test right away, and you may improve.”

The researchers think that if the new test was widely used, it could save hundreds of thousands of unnecessary trips to the doctor each year and cut down on the overprescribing of antibiotics.

The study will be published Nov. 5 in the Annals of Internal Medicine.

The question of what to do for adults who have bad sore throats is a tough one, even for doctors.

About 15 million Americans see a doctor for a sore throat each year, and 70 percent of them get antibiotics to treat it, according to the Infectious Diseases Society of America. That’s far more than the 20 percent to 30 percent of children and 5 percent to 15 percent of adults who actually benefit from taking the powerful drugs.

The problem is that most sore throats are caused by viruses, not bacteria, so antibiotics don’t help clear up the infection. Taking antibiotics when they aren’t needed can cause severe diarrhea and it contributes to the problem of antibiotic resistance — when bacteria can no longer be killed by the drugs that are available to fight them off.

But cases of strep throat, which is caused by bacteria, can be more dangerous.

“There are both medical, as well as considerable public health, reasons that we are concerned about strep throat,” said Dr. Edward Kaplan. A pediatric infectious disease specialist at the University of Minnesota, in Minneapolis, Kaplan wrote an editorial that accompanied the study.

These infections are highly contagious, and they may spread throughout the body, causing rashes, joint pain and lasting damage to the heart or kidneys.

Such serious aftereffects are rare, Kaplan said, but “they’re still common enough to cause mischief.”

Kaplan pointed to outbreaks of rheumatic fever caused by strep infections in Utah in the 1980s and 1990s, which sickened hundreds of adults.

The fear of missing strep infections combined with patient expectation that they’ll get an antibiotic leads a lot of doctors to overtreat sore throats, he said. So, tools like a home test app could fill a need.

The problem, Kaplan said, is that the test requires information about how common strep infections are in a local area, but strep infections are not reported publicly.

In the study, researchers relied on data generated by MinuteClinics, a chain of urgent care centers located in CVS drugstores.

MinuteClinics give every patient who comes in with a sore throat a test for strep bacteria. Researchers divided the number of positive results by the total number of patients tested in the last two weeks to calculate risk scores.

The study found that 90 percent of patients who were at low risk for strep based on their home test score also had negative lab tests for strep at MinuteClinics.

But that kind of universal testing clashes with current clinical guidelines.

In a sense, the accuracy of the test depends on overtesting in the first place, which drives up health care costs, said Dr. Robert Centor, an internist at the University of Alabama at Birmingham. He wrote a second editorial on the study.

Centor thinks it would be much less expensive to get doctors to just follow clinical guidelines, and to prescribe generic antibiotics when strep is detected.

Centor also wondered whether people would actually use such an app, which only applies to people over 15 years of age.

“It fails the eyeball test to me. Does it look like people will do it?” he asked.

The study authors were more hopeful. They say health care is changing to reward doctors who provide good care without overtreating their patients.

“We think that tools that improve the accuracy and the judicious use of testing will actually be quite welcome in most segments of the medical community,” Mandl said.

Strep Throat Infection

Is this your child’s symptom?

  • Your child was diagnosed with a Strep throat infection
  • A doctor has told you your child probably has Strep throat or
  • Your child has a positive Strep test
  • Your child is taking an antibiotic for Strep throat and you have questions
  • You are worried that the fever or sore throat is not getting better fast enough

Symptoms of Strep Throat Infection

  • Pain, discomfort or raw feeling of the throat
  • Pain is made worse when swallows
  • Children less than 2 years of age usually can’t complain about a sore throat. A young child who does not want favorite foods may have a sore throat. They may also start to cry during feedings.
  • Other symptoms include sore throat, fever, headache, stomach pain, nausea and vomiting.
  • Cough, hoarseness, red eyes, and runny nose are not seen with Strep throat. These symptoms point more to a viral cause.
  • Scarlet fever rash (fine, red, sandpaper-like rash) is highly suggestive of Strep throat.
  • If you look at the throat with a light, it will be bright red. The tonsil will be red and swollen, often covered with pus.
  • Peak age: 5 to 15 years old. Not common under 2 years old unless sibling has Strep.

Cause of Strep Throat

  • Group A Strep is the only common bacterial cause of a throat infection. The medical name is Strep pharyngitis.
  • It accounts for 20% of sore throats with fever.
  • Any infection of the throat usually also involves the tonsils. The medical name is Strep tonsillitis.

Diagnosis of Strep Throat

  • Diagnosis can be confirmed by a Strep test on a sample of throat secretions.
  • There is no risk from waiting until a Strep test can be done.
  • If your child has cold symptoms too, a Strep test is usually not needed.

Prevention of Spread to Others

  • Good hand washing can prevent spread of infection.

When to Call for Strep Throat Infection

Call 911 Now

  • Severe trouble breathing (struggling for each breath, can barely speak or cry)
  • Fainted or too weak to stand
  • Purple or blood-colored spots or dots on skin with fever
  • You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

  • Trouble breathing, but not severe
  • Great trouble swallowing fluids or spit
  • Stiff neck or can’t move neck like normal
  • Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears.
  • Fever over 104° F (40° C)
  • Will not drink or drinks very little for more than 8 hours
  • Can’t open mouth all the way
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Urine is pink or tea (brown) color
  • Taking antibiotic more than 24 hours, and sore throat pain is severe. The pain is not better 2 hours after taking pain medicines.
  • Taking antibiotic more than 48 hours and fever still there or comes back
  • Taking antibiotic more than 3 days and other Strep symptoms not better
  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Strep throat infection on antibiotic with no other problems

Seattle Children’s Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice for a Strep Throat Infection

  1. What You Should Know About Strep Throat:
    • Strep causes 20% of throat and tonsil infections in school age children.
    • Viral infections cause the rest.
    • Strep throat is easy to treat with an antibiotic.
    • Complications are rare.
    • Here is some care advice that should help.
  2. Antibiotic by Mouth:
    • Strep infections need a prescription for an antibiotic.
    • The antibiotic will kill the bacteria that are causing the Strep throat infection.
    • Give the antibiotic as directed.
    • Try not to forget any of the doses.
    • Give the antibiotic until it is gone. Reason: To stop the Strep infection from flaring up again.
  3. Sore Throat Pain Relief:
    • Age over 1 year. Can sip warm fluids such as chicken broth or apple juice. Some children prefer cold foods such as popsicles or ice cream.
    • Age over 6 years. Can also suck on hard candy or lollipops. Butterscotch seems to help.
    • Age over 8 years. Can also gargle. Use warm water with a little table salt added. A liquid antacid can be added instead of salt. Use Mylanta or the store brand. No prescription is needed.
    • Medicated throat sprays or lozenges are generally not helpful.
  4. Pain Medicine:
    • To help with the pain, give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil).
    • Use as needed.
  5. Fever Medicine:
    • For fevers above 102° F (39° C), give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil).
    • Note: Fevers less than 102° F (39° C) are important for fighting infections.
    • For all fevers: Keep your child well hydrated. Give lots of cold fluids.
  6. Fluids and Soft Diet:
    • Try to get your child to drink adequate fluids.
    • Goal: Keep your child well hydrated.
    • Cold drinks, milk shakes, popsicles, slushes, and sherbet are good choices.
    • Solids. Offer a soft diet. Also avoid foods that need much chewing. Avoid citrus, salty, or spicy foods. Note: Fluid intake is much more important than eating any solids.
    • Swollen tonsils can make some solid foods hard to swallow. Cut food into smaller pieces.
  7. What to Expect:
    • Strep throat responds quickly to antibiotics.
    • The fever is usually gone by 24 hours.
    • The sore throat starts to feel better by 48 hours.
  8. Return to School:
    • Your child can return to school after the fever is gone.
    • Your child should feel well enough to join in normal activities.
    • Children with Strep throat need to be taking an antibiotic for at least 12 hours.
  9. Call Your Doctor If:
    • Trouble breathing or drooling occurs
    • Dehydration suspected
    • Fever lasts more than 2 days after starting antibiotics
    • Sore throat lasts more than 3 days after starting antibiotics
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 12/10/2021

Last Revised: 10/21/2021

Copyright 2000-2021. Schmitt Pediatric Guidelines LLC.

Do I Have COVID or Strep Throat?

Sore throats in the fall months are common, and many people will wonder if they have strep throat or COVID-19, so what is the difference and how do you know if you have COVID or strep throat?

Craig P. Chase, M.D., a partner of Oviedo Medical Research, says, “Aside from getting body aches and fatigue, you don’t tend to have a lot of other symptoms with strep throat. You don’t tend to get runny noses; you don’t get cough or other respiratory problems. It usually is isolated just to the throat.”


What are the Differences and Similarities Between Strep and COVID?

Strep throat differs from COVID and even influenza in the underlying cause of the disease. The flu and COVID are both transmitted through viruses. Flu is caused by influenza viruses and COVID is caused by the 2019 novel coronavirus (SARS-CoV-2). Both cause respiratory illness that can be severe. In the case of COVID-19, many people have died from the disease.

Strep throat is a bacterial infection caused by group A Streptococcus bacteria. Although COVID, flu, and strep are different types of infections in the body, they are transmitted from person to person through tiny airborne droplets infected with these illnesses. Coughing, sneezing, or even talking, can spread these bacteria and viruses, and in the case of COVID-19, sometimes with deadly results.

What Are the Symptoms of COVID vs. Strep?

While COVID and strep can be transmitted through infected droplets from a sick person, there are some differences in how you will feel if you contract either of these disorders. For example, COVID symptoms include:

  • Chills and fever
  • Congestion or a runny nose
  • Coughing
  • Diarrhea
  • Fatigue
  • Headache
  • Loss of taste or smell
  • Nausea or vomiting
  • Shortness of breath
  • Sore throat

Influenza presents with many of these same symptoms, but it doesn’t cause the disruption to your sense of smell and taste that COVID does. Also, sore throat may or may not show up if you’re infected with COVID 19. One study from China of more than 55,000 COVID-19 patients showed that only 14% had sore throat symptoms with the virus.

The symptoms of strep throat are different from both COVID and the flu. According to Dr. Chase, strep throat presents as an “incredibly sore throat, painful to swallow, and you’re going to have a fever. On a physical exam, when you look in the throat, it’s typically bright red—fire engine red—and you’ve got yellow, gunky stuff all over your tonsils.” 

Strep throat symptoms include:

  • A body rash
  • Fever
  • Headache
  • Hoarseness 
  • Nausea or vomiting—especially in children
  • Pain when swallowing
  • Small red spots on the roof of your mouth
  • Swollen, red tonsils with white or yellow patches
  • Swollen, tender lymph nodes on your neck just under your ears

These symptoms are not present in COVID; while you may have a sore throat, there are other symptoms, including coughing, difficulty breathing and loss of smell and taste that are completely different from strep throat. Too, strep throat appears fairly suddenly, while COVID takes longer to incubate and show symptoms. 

When is it Time to See a Doctor?

It can be hard to know if your sore throat is strep-related or a part of COVID. In any case, if you’re worried you may have COVID or strep, it is definitely time to see your doctor. Strep throat is more common in children typically, but if one person has it, it’s highly infectious and may spread. It’s a good idea to seek medical care, where your doctor can examine, diagnose, and test for these illnesses—and then provide treatment.

A simple rapid strep test or throat culture can determine if you have the disease. Your doctor can’t make a guess that you have strep, but should back up the diagnosis with testing. A swab of the throat that is sent to the lab can confirm the diagnosis. The treatment for strep is with antibiotics to heal the infection.

To test for COVID, doctors will use a long swap to take a nose or throat sample. Like strep, the samples are sent to the lab for diagnosis. Unlike strep, there is currently no cure for COVID-19.

If your symptoms worsen for either illness, you may also need to seek emergency medical care, particularly if you’re having trouble breathing, which is one of the biggest issues that put COVID patients in the hospital. Some of the urgent warning signs for COVID-19 include:

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • Confusion or the inability to stay awake
  • Blue face or lips

If these symptoms occur, either call 911 or seek emergency care immediately. 
Typically, you can convalesce from strep throat and COVID while at home, although many patients with the coronavirus are being hospitalized with severe symptoms of the illness. Unlike COVID-19, which, as we write this, has killed nearly 200,000 patients, the CDC estimates there are roughly up to 24,000 cases of strep annually with up to 1,900 patients that die from the disease.

Strep Throat (for Teens) – Nemours KidsHealth

What Is Strep Throat?

Strep throat is a contagious disease, which means you catch it from another person. It is caused by infection with bacteria called group A streptococci (pronounced: strep-toe-KAH-kye) bacteria, and it’s very common among teens. In fact, strep bacteria cause almost a third of all sore throats.

Strep throat usually requires a trip to the doctor and treatment with antibiotics. With the proper medical care — along with plenty of rest and fluids — you should be back on your feet in no time.

What Are the Signs & Symptoms of Strep Throat?

Most sore throats are caused by viruses. If you have a runny nose, cough, hoarseness, and red or runny eyes, it’s probably a virus and will clear up on its own.

Strep throat is different. Signs that you may have strep throat include:

  • red and white patches in the throat
  • trouble swallowing
  • tender, swollen glands (lymph nodes) on the sides of your neck
  • red, big tonsils
  • headache
  • stomach pain
  • fever
  • feeling weak or sick
  • loss of appetite and nausea
  • rash

If you have any of these symptoms, it’s definitely time to see your doctor.

Is Strep Throat Contagious?

Strep throat is very contagious. Anybody can get it, but most cases are in school-age kids and teens. 

How Do People Get Strep Throat?

Students tend to get strep throat most often during the school year when big groups of people are close together.

The bacteria that cause strep throat tend to hang out in the nose and throat, so sneezing, coughing, or shaking hands can easily spread the strep infection from one person to another. That’s why it’s so important to wash your hands as often as possible.

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How Is Strep Throat Diagnosed?

A doctor often can do a rapid strep test right in the office. He or she will use a swab to take a sample of the fluids at the back of your throat. It usually only takes a few minutes to find out if you’ve got strep throat.

If the first test doesn’t prove anything, then your doctor might do a longer test called a throat culture. The doctor will rub a swab of fluid from your throat on a special dish and the dish will be left to sit for 2 nights. If you have strep throat, streptococci bacteria will usually grow in the dish within 1-2 days.

How Is Strep Throat Treated?

If you have strep throat, your doctor will give you a prescription to take antibiotics for 10 days. These will probably be pills that you swallow.

You will begin to feel better about 24 hours after starting treatment. Even if you don’t feel sick anymore, it’s important to take the antibiotics for the full 10 days. If you don’t finish all the antibiotics, you’re at risk for developing rheumatic fever, which can lead to permanent heart damage.

Sometimes a doctor might choose to treat strep throat with one antibiotic shot, without prescribing any medicine for you to take at home.

Can Strep Throat Be Prevented?

To protect others from getting sick, it’s important to stay home for at least 24 hours until the antibiotics have had a chance to work. Wash your forks, spoons, plates, and cups in hot, soapy water after you use them. Don’t share food, drinks, napkins, handkerchiefs, or towels with other people.

Cover your mouth and nose when you sneeze or cough to prevent passing fluid droplets to someone else. If you don’t have a tissue handy, make sure you cough or sneeze into your elbow — not your hands! Wash your hands often, especially after wiping or blowing your nose.

How Can I Feel Better?

Drink lots of cool liquids, such as water or ginger ale, especially if you have a fever, since you’ll feel worse if you become dehydrated. Stay away from orange juice, lemonade, and other acidic drinks because they can sting your throat. Frozen foods such as ice cream or popsicles can help to numb throat soreness. Warm liquids like soups, tea with honey, or hot chocolate also can be soothing.

Ask your doctor before using throat drops or over-the-counter throat sprays because these might make a strep infection feel worse.

Sore throat causes & treatments – Illnesses & conditions

Sore throats are not usually serious and often pass in three to seven days. There are some treatments you can use at home to relieve your symptoms.


For treating sore throats, over-the-counter painkillers, such as paracetamol, are usually recommended. These may also help reduce a high temperature (fever).

You should not take aspirin or ibuprofen if you have:

  • asthma
  • current or past stomach problems, such as a stomach ulcer
  • current or past liver or kidney problems

Children under the age of 16 should never be given aspirin.

Take painkillers as necessary to relieve your pain. Always read the manufacturer’s instructions so you do not exceed the recommended or prescribed dose.

Self-care tips

If you or someone in your family has a sore throat, the tips below may help relieve the symptoms:

  • avoid food or drink that is too hot, as this could irritate the throat
  • eat cool, soft food and drink cool or warm liquids
  • adults and older children can suck lozenges, hard sweets, ice cubes or ice lollies
  • avoid smoking and smoky environments
  • regularly gargling with a mouthwash of warm, salty water may help reduce swelling or pain
  • drink enough fluids, especially if you have a fever

Steam inhalation is not recommended, as it’s unlikely to help a sore throat and there is a risk of scalding.


The use of antibiotics is not usually recommended for treating sore throats. This is because most sore throats are not caused by bacteria.

Even if your sore throat is caused by bacteria, antibiotics have very little effect on the severity of the symptoms and how long they last, and may cause unpleasant side effects.

Overusing antibiotics to treat minor ailments can also make them less effective in the treatment of life-threatening conditions. This is known as antibiotic resistance.

Antibiotics are usually only prescribed if:

  • your sore throat is particularly severe
  • you are at increased risk of a severe infection – for example because you have a weakened immune system due to HIV or diabetes(a long-term condition caused by too much glucose in the blood)
  • you are at risk of having a weakened immune system – there are some medications that can cause this, such as carbimazole (to treat an overactive thyroid gland)
  • you have a history of rheumatic fever (a condition that can cause widespread inflammation throughout the body)
  • you have valvular heart disease (a disease affecting the valves in your heart, which control blood flow)
  • you experience repeated infections caused by the group A streptococcus bacteria

Delayed antibiotics prescription

If your pharmacist thinks you might need antibiotics, they may recommend you see your GP who might issue a prescription but ask you to wait up to three days for symptoms to improve.

If your sore throat gets worse, or has not improved after three days, you should have instructions to either:

  • take your prescription slip to a pharmacy
  • return to the GP surgery after three days to collect your medication

Recent studies show that complications of a sore throat are uncommon and usually not serious. A delayed antibiotic prescription seems to be as effective as an immediate prescription in reducing complications.

Using a delayed prescription provides similar benefits to an immediate prescription. Most importantly, this helps you to avoid taking antibiotics when they’re not needed and helps prevent antibiotic resistance.


A tonsillectomy is a surgical procedure to remove the tonsils (the two lumps of tissue on either side of your throat). If your child has repeated infections of the tonsils (tonsillitis), a tonsillectomy may be considered.

Read more about treating tonsillitis.

Glandular fever

If you are 15-25 years of age with a persistent sore throat, you may have glandular fever(also known as infectious mononucleosis, or mono). This is a type of viral infection with symptoms that can last up to six weeks.


A persistent sore throat can also be a symptom of some types of cancer, such as throat cancer. This type of cancer is rare and mainly affects people over the age of 50. In the UK every year, 5,300 people are diagnosed with cancer of the oropharynx (the area at the back of your throat) or mouth.

Read more about mouth cancer

Non-infectious causes

In some cases, a sore throat may be caused by substances that irritate the throat. Sources can include:

You may find that avoiding these substances, or seeking treatment for an allergy or GORD, can help to reduce symptoms of a sore throat.

Giving up smoking

If you smoke, giving up will reduce irritation to your throat and strengthen your defences against infection.

The Quit Your Way Scotland service can offer you advice and encouragement to help you quit smoking. Phone Quit Your Way Scotland free on 0800 84 84 84 (8.00am to 10.00pm, every day).

Your GP or pharmacist will also be able to give you help and advice about giving up smoking, or you can read more about quitting smoking.

Preventing a sore throat

As sore throats are caused by bacterial or viral infections, they can be difficult to prevent.

If you have a sore throat caused by an infection, you can help prevent the infection spreading by practising good hygiene, such as washing your hands regularly and keeping surfaces clean and free of germs.


90,000 Prevention of streptococcal (group A) infection

Prevention of streptococcal (group A) infection

Streptococcal infections – a group of diseases that includes infections caused by streptococcal flora of various types and manifested in the form of damage to the respiratory tract and skin. Streptococcal infections include streptococcal impetigo, streptoderma, streptococcal vasculitis, rheumatism, glomerulonephritis, erysipelas, sore throat, scarlet fever and other diseases.Streptococcal infections are dangerous with a tendency to develop post-infectious complications from various organs and systems. Therefore, diagnostics includes not only the identification of the pathogen, but also instrumental examination of the cardiovascular, respiratory and urinary systems.

Characteristic of the causative agent

Streptococcus is a genus of facultative anaerobic gram-positive globular microorganisms that are resistant to the environment. Streptococci are resistant to desiccation, persist in dried biological materials (sputum, pus) for several months.At a temperature of 60 ° C. die after 30 minutes, under the influence of chemical disinfectants – after 15 minutes.
Source of streptococcal infection – a carrier of streptococcal bacteria or a person who is sick with one of the forms of infection.
Gear mechanism – aerosol. The pathogen is secreted by the patient when coughing, sneezing, during a conversation. Infection occurs by airborne droplets, therefore, the main sources of infection are people with a predominant lesion of the upper respiratory tract ( angina , scarlet fever).At the same time, it is no longer possible to become infected at a distance of more than three meters. In some cases, it is possible to implement alimentary and contact transmission routes (through dirty hands, contaminated food). For group A streptococci, when certain food products (milk, eggs, shellfish, ham, etc.) enter a favorable nutrient medium, reproduction and long-term preservation of virulent properties are characteristic.
The likelihood of purulent complications during infection with streptococci is high in people with burns, wounds, pregnant women, newborns, patients after surgery.Group B streptococci usually cause infections of the genitourinary tract and can be transmitted through sexual intercourse. Newborns often get infections as a result of infection of the amniotic fluid and during the passage of the birth canal. The natural susceptibility of a person to streptococcal bacteria is high, the immunity is type-specific and does not prevent infection with streptococci of another species.

Clinical forms of streptococcal infection

The symptoms of streptococcal infections are extremely diverse due to the large number of possible localizations of the focus of infection, the types of pathogen.In addition, the intensity of clinical manifestations depends on the general condition of the infected organism. Group A streptococci are prone to damage to the upper respiratory tract, hearing aid, skin (streptoderma), this group includes the causative agents of scarlet fever and erysipelas.
Diseases developed as a result of damage by these microorganisms can be divided into primary and secondary forms. Primary forms represent a failure of inflammatory infectious diseases of the organs that have become the gates of infection (pharyngitis, laryngitis, tonsillitis, otitis media, impetigo, etc.).etc.). Secondary forms develop as a result of the inclusion of autoimmune and toxic-septic mechanisms of the development of inflammation in various organs and systems. Secondary forms of streptococcal infections with an autoimmune mechanism of development include rheumatism, glomerulonephritis and streptococcal vasculitis. Toxin-infectious character are necrotic lesions of soft tissues, meta- and peritonsillar abscesses, streptococcal sepsis.
Rare clinical forms of streptococcal infections: necrotic inflammation of muscles and fascia, enteritis, toxic shock syndrome, focal infections of organs and tissues (for example, soft tissue abscess).Group B streptococci overwhelmingly cause infections in newborns, although they occur at any age. This is due to the primary lesion of this causative agent of the genitourinary tract and intrapartum infection of newborns.
Group B streptococcal infections are often the cause of postpartum endometritis, cystitis, adnexitis in puerperas and complications in the postoperative period during cesarean section. In addition, streptococcal bacteremia can be observed in persons with a pronounced weakening of the body’s immune properties (elderly people, patients with diabetes mellitus, immunodeficiency syndrome, malignant neoplasms).Often, against the background of ongoing ARVI, streptococcal pneumonia develops. Greening streptococcus can cause endocarditis and subsequent valvular defects. Streptococcus mutans cause caries.
Complications of streptococcal infections are autoimmune and toxicoseptic secondary lesions of organs and systems (rheumatism, glomerulonephritis, necrotizing myositis and fasciitis, sepsis, etc.).

Diagnosis of streptococcal infections

Etiological diagnosis of streptococcal infection of the pharyngeal mucosa and skin requires a bacteriological study with the isolation and identification of the pathogen.An exception is scarlet fever. Since many streptococcal bacteria have now acquired some resistance to certain groups of antibiotics, a thorough microbiological examination and an antibiotic susceptibility test are necessary. A sufficient amount of diagnostics contributes to the choice of effective treatment tactics.
Express diagnostics of group A streptococci allow to establish the pathogen within 15-20 minutes from the moment of taking the analysis without isolating a pure culture.However, the identification of the presence of streptococci does not always mean that they are the etiological factor of the pathological process, this fact can also speak about the usual carrier. Rheumatism and glomerulonephritis are almost always characterized by an increase in the titer of antibodies to streptococci from the first days of exacerbation. The titer of antibodies to extracellular antigens is determined using a neutralization reaction. If necessary, an examination of the organs affected by streptococcal infection is carried out: examination by an otolaryngologist, X-ray of the lungs, ultrasound of the bladder, ECG, etc.

Treatment of streptococcal infections

Depending on the form of streptococcal infection, treatment is carried out by a gynecologist, urologist, dermatologist, pulmonologist or other specialists. Pathogenetic and symptomatic treatment depends on the clinical form of the disease.

Prevention of streptococcal infections

Prevention of streptococcal infection:

  • personal hygiene measures
  • individual prophylaxis in case of contacts in a narrow group with persons with respiratory diseases: wearing a mask, processing dishes and surfaces that could get microorganisms, washing hands with soap.

General prevention consists in the implementation of systematic control over the state of health of the collectives: preventive examinations in schools and kindergartens, isolation of identified patients, adequate therapeutic measures, identification of latent forms of streptococcal infection and their treatment.
Particular attention should be paid to the prevention of nosocomial infection with streptococcal infection, since infection in a hospital in a patient in a weakened state is many times more likely, and the course of infection in such patients is much more severe.Prevention of infection of women in labor and newborns consists in careful observance of sanitary and hygienic standards and regimen developed for gynecological departments and maternity hospitals.
Angina is an infectious-allergic process, local changes in which affect the pharyngeal lymphoid ring, most often the palatine tonsils. The course of angina is characterized by an increase in body temperature, general intoxication syndrome, sore throat when swallowing, enlargement and soreness of the cervical lymph nodes.Examination reveals hyperemia and hypertrophy of the tonsils and palatine arches, sometimes purulent plaque. Angina is diagnosed by an otolaryngologist on the basis of pharyngoscopy data and bacteriological culture from the pharynx. With angina, local treatment is indicated (gargling, washing lacunae, treating tonsils with drugs), antibiotic therapy, physiotherapy.


Angina is a group of acute infectious diseases that are accompanied by inflammation of one or more tonsils of the pharyngeal ring.The tonsils are usually affected. Less commonly, inflammation develops in the nasopharyngeal, laryngeal or lingual tonsils. The causative agents of the disease penetrate into the tissue of the tonsils from the outside (exogenous infection) or from the inside (endogenous infection). From person to person, angina is transmitted by airborne droplets or alimentary (food). With endogenous infection, microbes enter the tonsils from carious teeth, sinuses (with sinusitis) or the nasal cavity. When immunity is weakened, angina can be caused by bacteria and viruses that are constantly present on the mucous membrane of the mouth and pharynx.

Classification of sore throats

In otolaryngology, there are three types of angina:

Primary tonsillitis (other names are banal, simple or common tonsillitis). Acute inflammatory disease of a bacterial nature. Characterized by signs of a general infection and symptoms of damage to the lymphoid tissue of the pharyngeal ring.

Secondary tonsillitis (symptomatic tonsillitis). It is one of the manifestations of another disease.Some acute infectious diseases (infectious mononucleosis, diphtheria, scarlet fever), diseases of the blood system (leukemia, alimentary toxic aleukia, agranulocytosis) may be accompanied by the defeat of the tonsils.

Specific angina . The disease is caused by a specific infectious agent (fungi, spirochete, etc.).

Primary tonsillitis


About 85% of all primary sore throats are caused by group A ß-hemolytic streptococcus.In other cases, pneumococcus, Staphylococcus aureus or mixed flora acts as the causative agent. Primary tonsillitis in terms of prevalence is in second place after ARVI. It develops more often in spring and autumn. It mainly affects children and adults under the age of 35. Usually transmitted by airborne droplets. Sometimes it develops as a result of endogenous infection. The likelihood of sore throat increases with general and local hypothermia, decreased immunity, hypovitaminosis, nasal breathing disorders, increased dryness of the air, after suffering from acute respiratory viral infections.

The general symptoms of angina are caused by the penetration of microbial waste products into the bloodstream. Microbial toxins can cause toxic damage to the cardiovascular and nervous system, provoke the development of glomerulonephritis and rheumatism. The risk of complications increases with frequent relapses of streptococcal sore throat.


Depending on the depth and nature of the lesion of the lymphoid tissue of the pharyngeal ring, catarrhal, lacunar, follicular and necrotic primary angina are isolated, depending on the severity – mild, moderate and severe angina.


The incubation period ranges from 12 hours to 3 days. Characterized by an acute onset with hyperthermia, chills, pain when swallowing, an increase in regional lymph nodes.

With catarrhal angina, subfebrile condition, moderate general intoxication, and mild signs of inflammation according to blood tests are observed. Pharyngoscopy reveals a diffuse bright hyperemia of the posterior pharyngeal wall, hard and soft palate.Catarrhal sore throat continues for 1-2 days. The outcome may be recovery or transition to another form of angina (follicular or catarrhal).

For follicular and lacunar tonsillitis, more pronounced intoxication is characteristic. Patients complain of headache, general weakness, pain in joints, muscles and heart area. Hyperthermia up to 39-40C is noted. In the general analysis of blood, leukocytosis is determined with a shift to the left. ESR increases to 40-50 mm / h.

Pharyngoscopic examination of a patient with lacunar angina reveals severe hyperemia, expansion of lacunae, edema and infiltration of the tonsils.Purulent plaque spreads beyond the lacunae and forms a loose plaque on the surface of the tonsil. Plaque has the appearance of a film or separate small foci, does not extend beyond the amygdala, and is easily removed. When plaque is removed, the tonsil tissue does not bleed.

With follicular sore throat, pharyngoscopy reveals hypertrophy and pronounced swelling of the tonsils, the so-called picture of the “starry sky” (multiple white-yellow festering follicles). With spontaneous opening of the follicle, a purulent plaque is formed, which does not spread beyond the amygdala.

For necrotizing tonsillitis, severe intoxication is characteristic. Persistent fever, confusion, repeated vomiting are observed. According to blood tests, pronounced leukocytosis with a sharp shift to the left, neutrophilia, a significant increase in ESR are revealed. Pharyngoscopy reveals a dense gray or greenish-yellow coating with an uneven, dull, pitted surface. When plaque is removed, the tonsil tissue bleeds. After rejection of areas of necrosis, tissue defects of an irregular shape with a diameter of 1-2 cm remain.The spread of necrosis beyond the amygdala to the posterior pharyngeal wall, uvula and arch is possible.


Early complications of angina (otitis media, lymphadenitis of regional lymph nodes, sinusitis, paratonsillar abscess, peritonsillitis) occur during the illness when inflammation spreads to nearby organs and tissues. Late complications of angina of infectious and allergic genesis (glomerulonephritis, rheumatic heart disease, articular rheumatism) develop 3-4 weeks after the onset of the disease.


Diagnosis is based on symptoms and pharyngoscopy. To confirm the nature of the infectious agent, a bacteriological examination of mucus from the tonsils and a serological blood test are performed.

Specific sore throats

Candidal (fungal) tonsillitis.

Caused by yeast-like fungi of the genus Candida albicans. In recent years, there has been an increase in the number of cases of candidal angina, due to the widespread use of glucocorticoids and antibiotics.Fungal sore throat, as a rule, develops against the background of another disease after long courses of antibiotic therapy.

General symptoms are not expressed or poorly expressed. Pharyngoscopic examination reveals dotted white or yellowish overlays on the tonsils, sometimes extending to the mucous membrane of the cheeks and tongue. Plaque is easily removed.

The diagnosis is confirmed by the results of mycological examination. Treatment consists in the abolition of antibiotics, the appointment of antifungal drugs, restorative therapy, washing the tonsils with solutions of nystatin and levorin.

Angina Simanovsky-Plaut-Vincent (ulcerative membranous tonsillitis).

Develops with chronic intoxication, exhaustion, hypovitaminosis, immunodeficiency. It is caused by representatives of the saprophytic flora of the oral cavity – the Vincent spirochete in symbiosis and the Plaut-Vincent stick.

General symptoms are not expressed or poorly expressed. One amygdala is usually affected. On its surface, superficial ulcers are formed, covered with a gray-green bloom with a putrid odor.When removing plaque, the tonsil bleeds. After rejection of the necrotic area, a deep ulcer is formed, which subsequently heals without the formation of a defect.


Erysipelas (erysipelas) is an infectious disease caused by group A streptococcus, mainly affecting the skin and mucous membranes, characterized by the occurrence of limited serous or serous-hemorrhagic inflammation, accompanied by fever and general intoxication.Erysipelas is one of the most common bacterial infections. Characteristic of the pathogen

Characteristics of the pathogen

Erysipelas is caused by group A beta-hemolytic streptococcus, most often of the species Streptococcus pyogenes, which has a diverse set of antigens, enzymes, endo- and exotoxins. This microorganism can be a constituent part of the normal flora of the oropharynx, be present on the skin of healthy people. The source of erysipelas infection is a person, both suffering from one of the forms of streptococcal infection, and a healthy carrier.

Erysipelas is transmitted by the aerosol mechanism, mainly by airborne droplets, sometimes by contact. The entrance gate for this infection is damage and microtrauma to the skin and mucous membranes of the oral cavity, nose, and genitals. Since streptococci often live on the surface of the skin and mucous membranes of healthy people, the risk of infection if basic hygiene is not followed is extremely high . The development of infection is facilitated by factors of individual predisposition.

Women get sick more often than men. The risk of developing erysipelas is 5-6 times higher in persons suffering from chronic tonsillitis and other streptococcal infections. Erysipelas of the face often develops in people with chronic diseases of the oral cavity, ENT organs, caries. The defeat of the chest and limbs often occurs in patients with lymphovenous insufficiency, lymphedema, edema of various origins, with fungal lesions of the feet, trophic disorders. Infection can develop in the area of ​​post-traumatic and postoperative scars.Some seasonality is noted: the peak incidence occurs in the second half of summer – early autumn.

The pathogen can enter the body through damaged integumentary tissues, or in case of an existing chronic infection, penetrate into the capillaries of the skin with the blood flow. Streptococcus multiplies in the lymphatic capillaries of the dermis and forms a focus of infection, provoking active inflammation, or latent carriage. The active reproduction of bacteria contributes to the massive release of their metabolic products (exotoxins, enzymes, antigens) into the bloodstream.The consequence of this is intoxication, fever, the development of toxic-infectious shock is likely.

Erysipelas classification

Erysipelas is classified according to several criteria: by the nature of local manifestations (erythematous, erythematous-bullous, erythematous-hemorrhagic and bullous-hemorrhagic forms), by the severity of the course (mild, moderate and severe forms depending on the severity of intoxication), by the prevalence of the process (localized common, migratory (wandering, creeping) and metastatic).In addition, primary, repeated and recurrent erysipelas are distinguished.

Relapsing erysipelas is a recurrent episode from two days to two years after the previous episode, or relapses later, but inflammation develops repeatedly in the same area. Repeated erysipelas occurs no earlier than two years later, or is localized in a place different from the previous episode.

Localized erysipelas is characterized by the limitation of infection to a local focus of inflammation in one anatomical region.When the focus leaves the boundaries of the anatomical region, the disease is considered common. Accession of phlegmon or necrotic changes in the affected tissues are considered complications of the underlying disease.

Erysipelas symptoms

The incubation period is determined only in the case of post-traumatic erysipelas and ranges from several hours to five days. In the overwhelming majority of cases (more than 90%), erysipelas has an acute onset (the time of onset of clinical symptoms is noted to within hours), fever develops rapidly, accompanied by symptoms of intoxication (chills, headache, weakness, body aches).A severe course is characterized by the occurrence of vomiting of central origin, seizures, delirium. A few hours later (sometimes the next day), local symptoms appear: in a limited area of ​​the skin or mucous membrane, there is a burning sensation, itching, a feeling of bloating and moderate pain when touching, pressing. Severe pain is characteristic of erysipelas of the scalp. There may be soreness of regional lymph nodes on palpation and movement. In the area of ​​the focus, erythema and swelling appear.

The peak period is characterized by the progression of intoxication, apathy, insomnia, nausea and vomiting, symptoms of the central nervous system (loss of consciousness, delirium). The area of ​​the focus is a dense bright red spot with clearly defined uneven borders (a symptom of “flames” or “map”), with pronounced edema. The color of erythema can range from cyanotic (with lymphostasis) to brownish (with impaired trophism). There is a short-term (1-2 s) disappearance of redness after pressing.In most cases, compaction, limitation of mobility and pain on palpation of regional lymph nodes are found.

Fever and intoxication persist for about a week, after which the temperature returns to normal, regression of skin symptoms occurs somewhat later. Erythema leaves behind fine scaly peeling, sometimes pigmentation. Regional lymphadenitis and skin infiltration in some cases can persist for a long time, which is a sign of a probable early relapse.Persistent edema is a symptom of developing lymphostasis. Erysipelas is most often localized on the lower extremities, then, according to the frequency of development, there is an erysipelas of the face, upper extremities, chest (erysipelas of the chest is most typical with the development of lymphostasis in the postoperative scar).

Erythematous-hemorrhagic erysipelas is characterized by the presence of hemorrhages from the area of ​​the local focus against the background of general erythema: from small (petechiae) to extensive, confluent. Fever in this form of the disease is usually longer (up to two weeks) and the regression of clinical manifestations is noticeably slower.In addition, this form of erysipelas can be complicated by necrosis of local tissues.

In the erythematous-bullous form in the area of ​​erythema, bubbles (bullae) are formed, both small and rather large, with transparent contents of a serous nature. Bubbles appear 2-3 days after the formation of erythema, they open themselves, or they are opened with sterile scissors. Bulla scars with erysipelas usually do not leave. With a bullous-hemorrhagic form, the contents of the vesicles are serous-hemorrhagic, and, often, are left after erosion and ulceration are opened.This form is often complicated by phlegmon or necrosis; after recovery, scars and areas of pigmentation may remain.

Regardless of the form of the disease, erysipelas has features of the course in different age groups. In old age, primary and repeated inflammation is usually more severe, with an extended period of fever (up to a month) and exacerbation of existing chronic diseases. Inflammation of the regional lymph nodes is usually not noted. The subsidence of clinical symptoms occurs slowly, relapses are frequent: early (in the first half of the year) and late.The frequency of relapses also varies from rare episodes to frequent (3 or more times per year) exacerbations. Often, recurrent erysipelas is considered chronic, while intoxication, often becomes quite moderate, the erythema has no clear boundaries and is paler, the lymph nodes are not changed.

Complications of erysipelas

The most common complications of erysipelas are suppuration: abscesses and phlegmon, as well as necrotic lesions of the local focus, ulcers, pustules, inflammation of the veins (phlebitis and thrombophlebitis).Sometimes secondary pneumonia develops, with a significant weakening of the body, sepsis is possible.

Phlegmonous erysipelas: acute period.

Long-term stagnation of lymph, especially with a recurrent form, contributes to the occurrence of lymphedema and elephantiasis. Complications of lymphostasis also include hyperkeratosis, papilloma, eczema, and lymphorrhea. After clinical recovery, persistent pigmentation may remain on the skin.

Diagnosis of erysipelas

Erysipelas is usually diagnosed based on clinical symptoms. It may be necessary to consult a dermatologist to differentiate erysipelas from other skin conditions. Laboratory tests show signs of a bacterial infection. As a rule, no specific diagnostics and isolation of the pathogen are performed.

Forecast and prevention of erysipelas

Erysipelas of a typical course usually has a favorable prognosis and, with adequate therapy, ends with recovery.A less favorable prognosis occurs in the case of complications, elephantiasis and frequent relapses. The prognosis also worsens in debilitated patients, elderly people, people suffering from vitamin deficiencies, chronic diseases with intoxication, disorders of digestion and lymphovenous apparatus, and immunodeficiency. General prevention of erysipelas includes measures for the sanitary and hygienic regime of medical institutions, compliance with the rules of asepsis and antiseptics when treating wounds and abrasions, prevention and treatment of pustular diseases, caries, streptococcal infections.Individual prevention consists in maintaining personal hygiene and timely treatment of skin lesions with disinfectants.

90,000 Causes and types of cough

Sore throat is such a nasty thing . Finding out what may be the cause, how to be treated and when to see a doctor.

📖 What is a sore throat . In medicine, sore throat is called pharyngitis . Pharyngitis can be acute and occur for various reasons .

1️⃣🆘 Caused by a viral or bacterial infection. It usually clears up on its own and does not require medical intervention . But it is important to know the symptoms in which it is still worth seeking help.

🍯 How to treat a sore throat caused by a virus . It cannot be treated with antibiotics – they are not effective against viruses and can cause unnecessary side effects (eg diarrhea) . Symptoms can only be relieved with anesthetic sprays and lozenges . If honey, lemon tea and hot chicken broth help you, why not, they can also relieve pain . Typically, sore throat caused by viruses resolves within 4–5 days .

2️⃣🦠 A special type of pharyngitis is streptococcal sore throat . In this case, a course of antibiotic of the penicillin group will already be prescribed.

You can determine this type of sore throat by the following symptoms:

– sore throat;

– enlarged lymph nodes;

– white spots of pus on the tonsils;

– absence of cough, runny nose and redness of the eyes;

– fever.

👨‍⚕️ When to see a doctor. If a sore throat is combined with a skin rash, shortness of breath, profuse salivation, swelling of the neck or tongue, difficulty opening the mouth, or if your chronic illness worsens.

🩹 How to identify streptococcus. A rapid Streptococcus test is available at a pharmacy. And you can take a swab for sowing culture from the throat in the laboratory. It will take 1–2 days to wait for it, but the result will be more accurate in comparison with the express test.

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Laura (otolaryngologists) St. Petersburg – latest reviews

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Show 10 reviews of 3019 90,000 The mechanism of action of bacteriophages, how it works.Phage sensitivity

the discovery of penicillin, the first antibiotic of natural origin, was initially perceived as a chance once and for all to defeat infectious diseases that claimed millions of lives. However, in the second half of the last century, the initial euphoria subsided: it turned out that bacteria, due to mutations, can acquire resistance to any antibiotic and even exchange these genes with each other. Thus began the “arms race” between humans and bacteria.

There is a fundamental difference between bacteriophage preparations and chemical antibiotics: an antibiotic, unlike a phage preparation, kills everything in its path, including the community of beneficial microscopic inhabitants of the body.

The co-evolution of bacteria and phages over the past 3 billion years has led to the fact that for almost any pathogenic bacterium there is a corresponding “killer” virus.

Unlike conventional antibiotics, bacteriophages modify their genetic programs themselves, which eliminates the problem of resistance. The result is high selectivity: a specific bacteriophage is usually effective against only one specific bacterial species or even a strain of bacteria.

The process of destruction of a bacterial cell by a bacteriophage includes several strictly programmed steps.

Action of bacteriophages

It is very important that bacteriophages do not touch non-“own” bacteria, therefore they do not cause the death of “good” microflora and, of course, are absolutely safe for cells of higher organisms, including humans.

Phage therapy has no side effects, such as allergies, dysbiosis, secondary infections (for example, fungal infections), which is often observed when taking antibiotics.Bacteriophages can be used in combination therapy with any drugs, including antibiotics.

Bacteriophage preparations are a solution, they are used either locally (for example, on the skin or mucous membranes), or taken orally. In the body, bacteriophages are concentrated in the places of greatest damage and multiply until they find the target bacteria. Once the target bacteria have run out, the phages are excreted from the body.

The main goal of phage therapy is to stop and reverse the infectious process in order to enable the body’s immune system to cope with the disease.

Bacteriophages are used to treat

Ideally, before starting treatment in a particular patient, a pathogenic bacterium should be cultured and a bacteriophage should be selected from the “collection” of already known bacterial viruses.

Bacteriophage preparations are difficult to standardize due to the specifics of production. Even an experienced specialist cannot always predict in advance the effectiveness of a particular drug in a particular patient, since different bacterial strains of bacteria can cause similar manifestations of the disease.The way out is the production of “cocktails” from phages capable of killing different strains and even types of pathogens. And such drugs already exist – these are complex or polyvalent preparations of bacteriophages

6 stages of bacteriophage


Adsorption of bacteriophages on bacterial cells

Special elements of the phage, located on the surface in the form of fibrils or spines, bind to specific surface molecules – receptors on their victim – bacteria.Until the bacteriophage is firmly attached to the surface of the bacterium, the next stage does not occur. Since there is a special blocking system.

Injection of bacteriophage nucleic acid into the cell

After tight attachment of the phage (adsorption), the genetic material of the bacteriophage is introduced into the body of the bacterium. For this, in the structure of the phage, nature has provided for the presence of special structures that act like a syringe.It is due to this that the phage, as it were, makes an injection, dissolves the membrane and introduces its genetic material into the bacterium. To do this, the phage has an aggressive enzyme to pierce the bacteria.

Assembly of phage particles

The assembly of young phages begins with the packaging of genetic material into icosahedral protein shells. Further, the tail joins the phages, various proteins necessary for its vital activity appear on the phage head.The number of young phages inside the bacteria increases. The new generation is preparing to leave the bacterial cell.

Replication of bacteriophage nucleic acid copies

When the phage DNA enters the bacterium, it can be dissolved by the bacteria’s enzymes. However, the phage protects its DNA with special sticky proteins that close the molecule in a ring, making it invulnerable. Further, the phage genetic material (DNA) is replicated directly in the bacterial cell.

Synthesis of protein and nucleic acid particles

After infection of the bacteria, the restructuring of cellular metabolism begins to suit the needs of the phage: some cellular proteins are destroyed. Then, the phage genetic material is included in the metabolism of the bacterium and the assembly of new, young phages begins.

Release of mature phages and death of bacteria

The end of the phage life cycle is cell lysis. Young phages use to destroy the bacterial cell a set of enzymes that break down the bacterial membranes (lysines), and proteins that create pores in the inner membrane of the bacterium and accelerate the action of the enzyme lysine.


Only individual intolerance.

From a clinical point of view, phages are quite safe, since humans are born with them. Phages are constant companions of the body, they were found in the gastrointestinal tract, skin, urine, mouth, where they are contained in saliva. Bacteriophages are a safe alternative to antibiotics.

Comparison of prophylactic and therapeutic use of phages and antibiotics

Effects on bacteria

Phages effectively kill sensitive bacterial cells (their action is bactericidal).

Some antibiotics (eg chloramphenicol) are bacteriostatic; they inhibit bacterial growth rather than kill cells.

Selectivity of action

The high selectivity of bacteriophages allows targeting specific pathogens without affecting the normal bacterial flora (for example, it is unlikely that phages will be hostile to the normal flora of patients).

Antibiotics attack not only bacteria that cause disease, but also all sensitive microorganisms, including the normal – and often beneficial – microflora of the host.Therefore, their non-selective action disrupts the microbial balance in the patient’s body, which can lead to various side effects.

Side effects

Minor side effects when using therapeutic phages (can be caused by the release of endotoxins from bacteria lysed in vivo by phages).

Antibiotics have many side effects, including intestinal upset, allergies, and secondary infections (such as fungal infections).

Development of new drugs

The natural co-evolution of bacteria and phages can facilitate the production of new lytic phages against phage-resistant bacteria that arise as a result of the action of other phages or natural changes in bacterial populations.

The development of new antibiotics (for example, against antibiotic-resistant bacteria) is time-consuming and can take many years.

Resistance of bacteria to the action of the drug

Due to the specificity of the phages, the emergence of resistance in other bacterial species that are not targets of therapy is unlikely.

Due to the broad spectrum of activity, antibiotics can lead to the selection of resistant mutants in many bacterial species, not just target strains.

Application of the drug

Due to the specificity of phages, their successful use for the prevention and treatment of bacterial infections requires identification of the etiological agent and determination of its phage sensitivity to the drug in vivo before starting phage treatment.

Antibiotics prescribed empirically prior to identification of the etiological agent are more likely to be effective than phage drugs.

Laryngotracheitis – Lor Medical Service


Laryngotracheitis is an infectious and inflammatory lesion of the larynx and trachea, accompanied by signs of an acute respiratory infection.

In adults, laryngotracheitis is manifested by respiratory disorders and a painful cough, and in children it can manifest itself with signs of a severe complication – false croup.


Laryngotracheitis usually develops in children, although adults can also get sick. Often, laryngotracheitis is a complication of an acute respiratory infection or occurs when the immune defense is reduced either in the respiratory system or the whole body as a whole. Diseases can occur each separately – laryngitis or tracheitis, but usually, due to the structural features of the organs, they run together and give similar clinical manifestations.

The main causes of laryngotracheitis are:

  • respiratory viral lesions (influenza, parainfluenza and adenovirus are especially dangerous),
  • bacterial lesions (streptococcal or staphylococcal, tuberculous),
  • mycoplasma lesions,
  • herpes lesions,
  • allergic reasons,
  • chemical agents.

The provoking factors for the development of laryngotracheitis are:

  • Inhalation of dusty and gassed air.
  • Hearing Scream,
  • loud singing,
  • smoking, alcohol,
  • Symptoms of general hypothermia or freezing of the legs.

Development mechanism

The trachea performs the function of an air-conducting tube and in case of inflammation, edema may occur in the area of ​​its mucous membrane. This leads to the formation of contents that are difficult to separate, irritating the receptors and disrupting the conduction of air masses.

The larynx, in addition to the air-conducting function, also plays the role of a voice-forming element. Due to the vocal cords. Air currents and vibrations of the ligaments create a certain sound that is heard by the ear.

In case of inflammation, the vocal cords are damaged and swollen, and the region of the ligamentous tissue begins to accumulate fluid and squeeze the larynx region.

A complication may occur – false croup (edema with compression of the airways and suffocation).


Acute and chronic laryngotracheitis are distinguished. Acute laryngotracheitis is divided into

  • primary, which is detected for the first time,
  • relapsing, reoccurring, in the event of colds or adverse factors.

Primary acute laryngotracheitis can have three variants of the course:

  • sudden laryngotracheitis without signs of acute respiratory infections,
  • acutely arising, against the background of an existing acute respiratory disease,
  • gradually arising as a complication of colds.

Along the course, acute laryngotracheitis can be continuous or wavy.

Chronic laryngotracheitis occurs with incorrect treatment of acute or in the absence of treatment. Often occurs with professional overstrain of the ligaments.

There are three forms of the disease:

  • Catarrhal, in which there is redness and some swelling in the vocal cords and trachea
  • is atrophic, there is a gradual atrophy in the area of ​​the mucous membrane, due to which it loses its protective properties and becomes inflamed.Often among smokers and coal mine workers, people working in dusty environments
  • hyperplastic, the proliferation of areas or the entire zone of the mucous membrane in the trachea and larynx region is manifested, as a result, breathing and voice suffer

Manifestations of acute laryngotracheitis

Acute laryngotracheitis manifests itself against the background of ARVI, starting acutely or gradually. Occur:

  • a sharp jump in temperature,
  • sore throat,
  • rawness in the chest,
  • rough, dry cough with soreness,
  • the cough has a croaking or barking character due to sharp swelling and spasm of the vocal cords,
  • when coughing, chest pain worsens,
  • coughing attacks occur with laughter, deep breathing, inhalation of dusty or cold air,
  • a small amount of thick and viscous sputum is secreted,
  • hoarseness or hoarseness in voice,
  • Discomfort in the larynx with dryness, chewing.

As the process develops, the cough becomes moist, less painful, with a large amount of mucopurulent sputum.

Cervical lymph nodes may react – they become painful and enlarged. When listening to the lungs, hard breathing and dry wheezing in the tracheal projection are noted.

Symptoms of a chronic process

Chronic laryngotracheitis occurs gradually, main symptoms:

  • voice disorders, from mild dysphonia and hoarseness, up to the complete absence of voice – aphonia,
  • attacks of coughing, provoked by laughter, cold or deep breathing,
  • soreness in the larynx and behind the sternum,
  • Voice fatigue may occur (with prolonged singing or talking).

Exacerbations of chronic laryngotracheitis can occur during hormonal changes in women, during hypothermia, after stress, after severe stress on the ligaments – when screaming, singing with anguish.

In chronic laryngotracheitis, the cough is usually constant, with a small amount of sputum, and against the background of exacerbations, coughing attacks become more frequent and sputum becomes more. Against the background of a cough, in the trachea and larynx, there may be a feeling of itching and dryness.


The basis of the diagnosis is the patient’s typical complaints – a hoarse voice, dry cough and chest pain, as well as examination and listening to the lungs and trachea.

The diagnosis is supplemented by micro-laryngoscopy and tracheoscopy – examination of the vocal cords and larynx using a special apparatus. Sputum culture is carried out with the identification of the pathogen, if necessary, X-rays and CT scans of the larynx and trachea are prescribed.

In chronic laryngotracheitis, it is necessary to perform laryngoscopy with a piece of tissue for biopsy in order to exclude cancer, and if wheezing occurs, a chest x-ray with the exception of pneumonia and bronchitis.

It is important to distinguish laryngotracheitis from a foreign body of the larynx and trachea from diphtheria and laryngeal papillomatosis, retropharyngeal abscesses.

Treatment of laryngotracheitis

ENT doctors are engaged in the treatment of laryngotracheitis, with an uncomplicated course, the treatment is carried out on an outpatient basis, under the supervision of a polyclinic doctor.

In case of an acute or exacerbated chronic process, to relieve coughing, it is necessary to take a large amount of warm liquids in the form of tea, compotes. Indoor air requires moisture and coolness.

With the viral nature of the disease, antiviral and immunomodulatory therapy is prescribed. In the microbial process – broad-spectrum antibiotics.

  • Eating small meals frequently and drinking plenty of fluids
  • Warm humid indoor air
  • Inhalation of vasoconstrictors, for example, 0.1% epinephrine solution (in the absence of contraindications, such as tachycardia)
  • For severe course – inhalation flunisolide, beclomethasone
  • For infections caused by parainfluenza – ribavirin, for influenza type A – rimantadine
  • To relieve cough – dextromethorphan 15-30 mg 1-4 times a day (children over 2 years old – 1 mg / kg / day) or codeine 10-20 mg per dose (children after 2 years old – 1.0-1, 5 mg / kg every 4-6 hours), if necessary in combination with bronchodilators

Supplements treatment reception:

  • antitussives (for dry, painful cough),
  • thinning phlegm (for dry cough),
  • inhalations with mineral water or saline,
  • electrophoresis is assigned to the larynx and trachea area.

In a chronic process against the background of the above treatment, immunomodulatory therapy, the appointment of increased doses of vitamins, massages, inhalations with medicinal herbs and physiotherapy are carried out.

The prognosis for laryngotracheitis is favorable, however, in people whose profession is associated with singing or long conversations, laryngotracheitis can disrupt voice formation, and become the cause of prof. unsuitability.

Streptococcal sore throat – Medical center “Liko-Med”

What is it?

Streptococcal sore throat is a throat disease caused by streptococci.Its main symptoms are redness, sore throat (especially when swallowing), enlarged cervical lymph nodes, fever. As a rule, streptococcal sore throat is more severe than viral tonsillitis. Although streptococcal sore throat is more common in children 5–15 years old, adults are also susceptible to the disease. Subsequently, some children develop scarlet fever after a sore throat.

Streptococcal sore throat is transmitted to another person by airborne droplets when sneezing, sharing utensils, runny nose.If untreated, the disease can be complicated by rheumatism, nephritis, otitis media, meningitis. Antibiotics will help cure sore throat and scarlet fever and prevent, although rare, but serious complications.

What to expect

The severity of symptoms can range from mild discomfort to severe pain and fever. Typically, the illness begins with a sore throat that lasts 1 to 5 days. Fever peaks on day 2. In the event of a rash, it appears on the neck, breast skin, and then spreads throughout the body.With antibiotic treatment, the disease resolves within a week, and the rash is noticeable until 21 days.


Several million people suffer from streptococcal sore throat every year.


Streptococcal sore throat is treated with antibiotics, as they shorten the time of illness, prevent complications and reduce the infectiousness of the disease within a day of treatment.

What you can do yourself

To avoid getting infected, observe the following rules:

Wash your hands often, especially if you are in contact with other people,

Stay at home for at least a day from the start of treatment,

Wash your hands if you are near a sick person,

· use separate dishes and a towel while you are ill,

· avoid kissing,

· sneeze, cough — cover your mouth.

For angina:

gargle with warm salt water,

No smoking.

What makes it worse

Smoking, caffeine and not drinking enough fluids.

When to see a doctor

See a doctor if you notice symptoms of sore throat or if you have come into contact with sick people.It is also necessary to consult a doctor if there is no improvement after 1-2 days.

Call a doctor immediately if breathing or swallowing becomes difficult, as well as acute pain, bleeding, redness, swelling, profuse salivation.

What to ask a doctor about

1. What causes the symptoms – sore throat or other disease?

2. Is the disease contagious?

3. How to avoid infection to other family members?

4. Do I need to take sick leave?

5.How should you be treated to relieve pain?

Making the diagnosis

The doctor diagnoses streptococcal sore throat by taking anamnesis and conducting a medical examination, including a rapid test for streptococcus.

Risk factors

Young people, as well as those who have had contact with the patient.

90,000 Streptococcal pneumonia – causes, symptoms, diagnosis and treatment

Streptococcal pneumonia is an infectious inflammation of the lung tissue that develops with the participation of pathogenic bacteria of the genus Streptococcus.The disease more often affects children, mainly arises as a complication of other respiratory infections. Streptococcal pneumonia occurs with fever, cough, shortness of breath, chest pain; often complicated by purulent pleurisy, pericarditis, abscess formation, glomerulonephritis. The diagnosis is verified using X-ray of the lungs, determination of streptococcus in sputum, blood, or pleural aspirate. When confirming the streptococcal etiology of pneumonia, it is preferable to prescribe penicillins; if effusion is present, thoracocentesis may be required.

General information

Streptococcal pneumonia – bacterial pneumonia, the etiological agent of which is played by various types of streptococcus (beta-hemolytic, peptostreptococcus, etc.). Inflammation of the lungs caused by bacteria of the genus Streptococcus pneumoniae (pneumococcus) is usually considered in clinical pulmonology as an independent nosological form – pneumococcal pneumonia. The share of streptococcal pneumonia in the overall morbidity structure of adult patients is low – 1-4%.However, this pathogen often becomes the “culprit” of pneumonia in young children (20%), elderly and weakened persons, and also contributes to the development of purulent complications. Among focal pneumonia of various etiology, the proportion of streptococcal pneumonia is about 10%.

Streptococcal pneumonia


Representatives of the genus Streptococcus are the causative agents of a wide range of streptococcal infections. Most often, these microorganisms cause pharyngitis, tonsillitis, sinusitis, scarlet fever, otitis media, impetigo, but they can also cause meningitis, neonatal sepsis, infective endocarditis, brain and abdominal abscesses.

Lower respiratory tract infections – tracheobronchitis and streptococcal pneumonia are uncommon. Group A beta-hemolytic streptococci usually cause pneumonia in children, as well as in patients with diabetes mellitus and other severe comorbidities. There are known cases of mass morbidity among soldiers in military service (the largest epidemic of streptococcal pneumonia occurred in the First World War), but sporadic cases are usually found.

The method of penetration of streptococcus into the respiratory tract is airborne.The incidence of streptococcal pneumonia is higher in autumn and spring, during periods of ARVI outbreaks. In most cases, a bacterial lung infection complicates diseases such as influenza, measles, whooping cough, chickenpox, and sudden exanthema. Lung damage most often manifests itself in the form of segmental or interstitial pneumonia, less often – focal or lobar pneumonia.


Once in the respiratory tract, streptococcus causes ulceration and necrosis of the mucous membrane of the trachea and bronchi, accompanied by profuse exudation and hemorrhages.In the lung tissue, pathological changes usually affect the interalveolar septa. Through the lymphatic system, streptococcal infection quickly spreads to the lymph nodes of the root of the lung and mediastinum. In a hematogenous way, the pyogenic flora penetrates into the pleural cavity: effusion with streptococcal pneumonia is usually abundant, in nature it is serous (serous-hemorrhagic) or liquid purulent.

Symptoms of streptococcal pneumonia

The clinical picture of streptococcal pneumonia differs little from pneumonia caused by pneumococcus.Both etiological forms are characterized by a sudden onset with an increase in body temperature to 39 ° C, a rapid increase in intoxication. Against the background of fever, cough, shortness of breath, chest pains appear. Chills are rare. The cough, from dry and unproductive, soon becomes moist, with a discharge of mucopurulent sputum. “Rusty phlegm” is uncommon. If streptococcal pneumonia is preceded by a viral disease, then the addition of a bacterial infection may indicate an increase in the severity of ARVI.Intoxication and respiratory symptoms may be accompanied by the appearance of a scarlet fever-like rash.

A characteristic feature of streptococcal pneumonia is the frequent attachment of parapneumonic pleurisy and pleural empyema, which occur as early as 2-3 days of the disease. These complications occur in almost 60% of children and 50% of adults. Somewhat less often (in 35% of patients) purulent pericarditis, the formation of pulmonary abscesses in the area of ​​the pneumonic focus are noted. Cases of purulent arthritis, osteomyelitis, and glomerulonephritis are even rarer.

Separately, streptococcal pneumonia of newborns is isolated, which manifests itself in the first 5-7 days of a child’s life. Most often it serves as a manifestation of intrauterine sepsis caused by streptococcal infection. Such pneumonia occurs with severe respiratory disorders (tachypnea, dyspnea, episodes of apnea, diffuse cyanosis, increasing hypoxemia).


With the etiological verification of pneumonia, the pulmonologist takes into account the history (viral and bacterial infections), acute onset, and earlier pleurisy.Percussion and auscultatory data in streptococcal pneumonia are scarce, which is explained by the small size of the pneumonic foci. Meanwhile, in the general analysis of blood from the first days of the disease, there is a pronounced leukocytosis (up to 20-30×10 9 / l), a shift of the leukocyte formula to the left.

Radiography of the lungs reveals diffuse infiltrative shadows, more often in the middle and lower lobes. When an abscess is formed, a cavity with a horizontal fluid level is determined; the development of pleurisy is indicated by an intense homogeneous darkening with an oblique upper border.To establish the nature of the exudate (serous or purulent), a pleural puncture is performed.

An important part of confirming the diagnosis of streptococcal pneumonia is sputum culture. Streptococcus culture can also be isolated from other biological media – blood, pleural exudate. An increase in antistreptolysin-O (ASL-O) titers in the patient’s blood may indicate a streptococcal etiology of pneumonia. Differential diagnosis should be carried out with other types of pneumonia (pneumococcal, staphylococcal, atypical, etc.)).

Treatment of streptococcal pneumonia

The principles of treatment of streptococcal pneumonia do not differ from the main approaches to the treatment of bacterial pneumonia in general. The main links include the appointment of bed rest for the period of fever, antibiotic therapy, detoxification measures, and rehabilitation procedures.

The first-line antibiotics for streptococcal pneumonia are penicillins (penicillin G, carbenicillin, ampicillin, amoxicillin), which are often used in combination with aminoglycosides.Second- and third-line drugs are, respectively, macrolides and second-generation cephalosporins. Antibiotics are first administered parenterally, then after the onset of clinical improvement – orally for 2-3 weeks.

In order to detoxify, correct water-electrolyte balance and replenish protein losses, intravenous administration of glucose, water-salt solutions, plasma transfusion is carried out. In case of complication of streptococcal pneumonia with pleurisy (serous or purulent), repeated thoracocentesis or closed drainage of the pleural cavity with aspiration of exudate and subsequent rinsing with antiseptics or antibiotics is indicated.

In the late period, after the relief of the febrile intoxication syndrome, physiotherapeutic rehabilitation is prescribed (drug electrophoresis, UHF, inductothermy, microwave therapy, inhalation therapy), chest massage, exercise therapy.

Forecast and prevention

In general, mortality from streptococcal pneumonia is low. A protracted course of the disease and purulent complications with timely and rational antibiotic therapy are rare. Prevention consists in strengthening the protective functions of the body, sanitizing the foci of streptococcal infection in the nasopharynx.A measure of specific prevention of complications is the vaccination of children and the elderly against pneumococcal infection.