Symptoms, Causes, Diagnosis, and Treatment

Written by WebMD Editorial Contributors

Medically Reviewed by Poonam Sachdev on February 15, 2023

• What Is Strep Throat?
• Is Strep Throat Contagious? 
• Strep Throat Symptoms
• Strep Throat Diagnosis
• Strep Throat Treatment 
• Strep Throat Home Remedies
• Strep Throat Prevention
• Strep Throat Complications
• More

Strep throat is an infection of the throat and tonsils caused by a bacteria called group A streptococcus, which is also known as Streptococcus pyogenes. This bacteria lives in the nose and throat. You can get the infection from someone who is carrying strep A bacteria or is sick from it.

Anyone can get strep throat, but it’s most common in children and teens. 

The bacteria that cause strep throat pass easily from person to person through close contact.

Strep throat spreads when someone who has the infection coughs or sneezes. Droplets filled with bacteria spray into the air.

You can give yourself strep throat (or catch it from someone else) if you:

• Breathe it in
• Touch something these droplets land on, such as a doorknob or table, and then rub your eyes, nose, or mouth
• Share personal items such as a fork or spoon, glass, or toothbrush with someone who is sick
• Kiss a person who has it

When you get infected, you typically start to show symptoms about 2 to 5 days after you were exposed to the bacteria.

You can stay contagious for up to a month if you don’t get treated. Antibiotics can prevent the infection from spreading. People who take antibiotics stop being contagious after about 24 hours.

A sore throat is the main sign you or your child has strep. Colds and other viruses can also cause a sore throat. One way to tell the difference between strep throat and another virus is that a virus will often cause a runny nose, too.

With strep, the sore throat comes on quickly and is more likely to cause these other symptoms. Call your doctor if you or a child in your care has these symptoms:

• A fever of 101 F or higher

• Red, swollen tonsils

• Pain when you swallow

• Swollen and/or tender lymph nodes at the front of your neck

• White patches in the throat

• Tiny red spots on the roof of the mouth (called petechiae)

• Appetite loss

• Stomachache

• Headache

• Body aches

• Nausea or vomiting

• Loss of appetite

• Rash

Signs that the infection might be viral rather than caused by strep bacteria include:

To see whether you have strep throat, contact your health care professional. They’ll will ask about your or your child’s symptoms. The only sure way to tell strep from viruses that cause a sore throat is to do a test. There are two kinds of strep throat tests:

Rapid strep test: It can identify a case in just a few minutes. The doctor will gently hold down your or your child’s tongue with a depressor. Then, they will swipe a cotton swab around the back of the throat.

You’ll get the results in 20 minutes or less. If the test is positive, which means strep is there, the doctor may prescribe antibiotics to treat it.

If the test is negative, that means they didn’t find strep bacteria. Your doctor might send the sample to a lab for a follow-up test that takes longer.

A rapid strep test can be positive if you have a sore throat that’s caused by a virus. It can be difficult to tell what’s causing the sore throat in that situation because you’re carrying the bacteria and a virus. If you keep getting a sore throat after taking antibiotics, you (or your child) could have a viral throat infection and be a strep throat carrier. You might be less likely to spread it to other people, though.

Throat culture: The doctor will rub a swab over the throat and tonsils to be sent to the lab. If you or your child has strep throat, the streptococci bacteria will grow in it.

It usually takes about 2 days to get results from a throat culture. It can confirm whether it’s strep throat or not.

Your doctor may prescribe antibiotics to kill the bacteria that cause the infection. Most treatments last about 10 days. The medicine can make symptoms go away faster and help prevent complications.

If you or your child has a positive test but no symptoms, you’re probably just a carrier. In that case, you’re less likely to spread the bacteria to others, and unlikely to have complications. So you probably won’t need antibiotics. Your doctor can let you know if you need them or not.

Make sure you or your child takes all of the doses. Stopping the medicine too early can leave some bacteria alive. These can make you or your child sick again. Be sure to tell the doctor if you or your child is allergic to any types of antibiotics.

If the strep test is negative, a virus likely caused the sore throat. Antibiotics won’t be needed because these medications don’t kill viruses.

You can take medications to ease the pain of strep throat and lower fever, including over-the-counter medicines such as ibuprofen or acetaminophen. Don’t give aspirin to children or teens. It can cause a rare but dangerous condition called Reye’s syndrome. 

There are a number of things you can do at home to lessen pain and make you feel more comfortable:

• Gargle with a mixture of a quarter-teaspoon of salt and 8 ounces of warm water.
• Suck on a throat lozenge or piece of hard candy. But don’t give small pieces of candy to children younger than 4.
• Throw out your toothbrush and use a new one.
• Drink warm liquids such as tea and broth, and drink plenty of water to prevent dehydration .
• Suck on something cold such as an ice pop or ice chips.
• Choose soft foods that are easy to swallow such as soups, applesauce, or oatmeal. Pass on orange juice and other drinks that have a lot of acid. They’ll sting.
• Honey can help ease pain and inflammation.
• Use a humidifier and/or saline nasal sprays to keep your airways moist, which can help you feel more comfortable.
• Get lots of rest so your body can recover from the infection.

The best way to avoid strep is to stay away from anyone who looks or sounds sick. Signs of strep throat can include:

• A sore throat
• Swollen glands
• Fever
• Nausea or vomiting
• Rash

Try not to share any personal items with someone who is sick. This includes:

• Cups and plates
• Knives, forks, and spoons
• Toothbrushes
• Food and drinks

If you have strep, here are some things you or your child can do to avoid getting sick again:

• Take all the medicine your doctor prescribed, even if you start to feel better. Some bacteria may live and rebound if you stop the medication too soon.
• Once you’ve been on antibiotics for 2 to 3 days, throw out your old toothbrush and get a new one.
• Stay out of work or school for at least 24 hours after you start taking an antibiotic.
• Wash your hands and your children’s hands often. Or use an alcohol-based hand sanitizer several times a day. Always clean your hands before you eat and after you use the bathroom. 
• Ask your children to cover their mouths with a tissue or sleeve whenever they cough or sneeze. 

Strep complications are rare today, thanks to better diagnosis and treatment. But untreated strep throat can cause serious diseases, such as:

• The infection spreading to the tonsils, sinuses, middle ear, the mastoid bone behind the ear (mastoiditis), skin, or blood

• A peritonsillar abscess – it’s a collection of pus around the tonsils or behind the throat that can be extremely painful

Other strep complications involve an inflammatory response in different parts of your body, including:

• Scarlet fever, a red rash that can be tiny pin pricks that are hard to see or intense redness on the body that gives it its name

• Rheumatic fever, which can damage the heart, brain, and joints

• A kidney disease called glomerulonephritis

• Poststreptococcal reactive arthritis, which is inflammation in your joints

Another rare complication that is not well-understood is a condition called PANDAS, which stands for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. It usually involves developing the tics and habits of obsessive compulsive disorder (OCD) after a strep infection. Symptoms of OCD can worsen after a strep infection, too.

Guttate psoriasis, a skin condition in which tear drop scales appear on the surface of the skin. They may be red or silver in color and can be itchy.

Top Picks

Symptoms, Causes, Diagnosis, and Treatment

Written by WebMD Editorial Contributors

Medically Reviewed by Poonam Sachdev on February 15, 2023

• What Is Strep Throat?
• Is Strep Throat Contagious? 
• Strep Throat Symptoms
• Strep Throat Diagnosis
• Strep Throat Treatment 
• Strep Throat Home Remedies
• Strep Throat Prevention
• Strep Throat Complications
• More

Strep throat is an infection of the throat and tonsils caused by a bacteria called group A streptococcus, which is also known as Streptococcus pyogenes. This bacteria lives in the nose and throat. You can get the infection from someone who is carrying strep A bacteria or is sick from it.

Anyone can get strep throat, but it’s most common in children and teens. 

The bacteria that cause strep throat pass easily from person to person through close contact.

Strep throat spreads when someone who has the infection coughs or sneezes. Droplets filled with bacteria spray into the air.

You can give yourself strep throat (or catch it from someone else) if you:

• Breathe it in
• Touch something these droplets land on, such as a doorknob or table, and then rub your eyes, nose, or mouth
• Share personal items such as a fork or spoon, glass, or toothbrush with someone who is sick
• Kiss a person who has it

When you get infected, you typically start to show symptoms about 2 to 5 days after you were exposed to the bacteria.

You can stay contagious for up to a month if you don’t get treated.  Antibiotics can prevent the infection from spreading. People who take antibiotics stop being contagious after about 24 hours.

A sore throat is the main sign you or your child has strep. Colds and other viruses can also cause a sore throat. One way to tell the difference between strep throat and another virus is that a virus will often cause a runny nose, too.

With strep, the sore throat comes on quickly and is more likely to cause these other symptoms. Call your doctor if you or a child in your care has these symptoms:

• A fever of 101 F or higher

• Red, swollen tonsils

• Pain when you swallow

• Swollen and/or tender lymph nodes at the front of your neck

• White patches in the throat

• Tiny red spots on the roof of the mouth (called petechiae)

• Appetite loss

• Stomachache

• Headache

• Body aches

• Nausea or vomiting

• Loss of appetite

• Rash

Signs that the infection might be viral rather than caused by strep bacteria include:

To see whether you have strep throat, contact your health care professional. They’ll will ask about your or your child’s symptoms. The only sure way to tell strep from viruses that cause a sore throat is to do a test. There are two kinds of strep throat tests:

Rapid strep test: It can identify a case in just a few minutes. The doctor will gently hold down your or your child’s tongue with a depressor. Then, they will swipe a cotton swab around the back of the throat.

You’ll get the results in 20 minutes or less. If the test is positive, which means strep is there, the doctor may prescribe antibiotics to treat it.

If the test is negative, that means they didn’t find strep bacteria. Your doctor might send the sample to a lab for a follow-up test that takes longer.

A rapid strep test can be positive if you have a sore throat that’s caused by a virus. It can be difficult to tell what’s causing the sore throat in that situation because you’re carrying the bacteria and a virus. If you keep getting a sore throat after taking antibiotics, you (or your child) could have a viral throat infection and be a strep throat carrier. You might be less likely to spread it to other people, though.

Throat culture: The doctor will rub a swab over the throat and tonsils to be sent to the lab. If you or your child has strep throat, the streptococci bacteria will grow in it.

It usually takes about 2 days to get results from a throat culture. It can confirm whether it’s strep throat or not.

Your doctor may prescribe antibiotics to kill the bacteria that cause the infection. Most treatments last about 10 days. The medicine can make symptoms go away faster and help prevent complications.

If you or your child has a positive test but no symptoms, you’re probably just a carrier. In that case, you’re less likely to spread the bacteria to others, and unlikely to have complications. So you probably won’t need antibiotics. Your doctor can let you know if you need them or not.

Make sure you or your child takes all of the doses. Stopping the medicine too early can leave some bacteria alive. These can make you or your child sick again. Be sure to tell the doctor if you or your child is allergic to any types of antibiotics.

If the strep test is negative, a virus likely caused the sore throat. Antibiotics won’t be needed because these medications don’t kill viruses.

You can take medications to ease the pain of strep throat and lower fever, including over-the-counter medicines such as ibuprofen or acetaminophen. Don’t give aspirin to children or teens. It can cause a rare but dangerous condition called Reye’s syndrome. 

There are a number of things you can do at home to lessen pain and make you feel more comfortable:

• Gargle with a mixture of a quarter-teaspoon of salt and 8 ounces of warm water.
• Suck on a throat lozenge or piece of hard candy. But don’t give small pieces of candy to children younger than 4.
• Throw out your toothbrush and use a new one.
• Drink warm liquids such as tea and broth, and drink plenty of water to prevent dehydration .
• Suck on something cold such as an ice pop or ice chips.
• Choose soft foods that are easy to swallow such as soups, applesauce, or oatmeal. Pass on orange juice and other drinks that have a lot of acid. They’ll sting.
• Honey can help ease pain and inflammation.
• Use a humidifier and/or saline nasal sprays to keep your airways moist, which can help you feel more comfortable.
• Get lots of rest so your body can recover from the infection.

The best way to avoid strep is to stay away from anyone who looks or sounds sick. Signs of strep throat can include:

• A sore throat
• Swollen glands
• Fever
• Nausea or vomiting
• Rash

Try not to share any personal items with someone who is sick. This includes:

• Cups and plates
• Knives, forks, and spoons
• Toothbrushes
• Food and drinks

If you have strep, here are some things you or your child can do to avoid getting sick again:

• Take all the medicine your doctor prescribed, even if you start to feel better. Some bacteria may live and rebound if you stop the medication too soon.
• Once you’ve been on antibiotics for 2 to 3 days, throw out your old toothbrush and get a new one.
• Stay out of work or school for at least 24 hours after you start taking an antibiotic.
• Wash your hands and your children’s hands often. Or use an alcohol-based hand sanitizer several times a day. Always clean your hands before you eat and after you use the bathroom. 
• Ask your children to cover their mouths with a tissue or sleeve whenever they cough or sneeze. 

Strep complications are rare today, thanks to better diagnosis and treatment. But untreated strep throat can cause serious diseases, such as:

• The infection spreading to the tonsils, sinuses, middle ear, the mastoid bone behind the ear (mastoiditis), skin, or blood

• A peritonsillar abscess – it’s a collection of pus around the tonsils or behind the throat that can be extremely painful

Other strep complications involve an inflammatory response in different parts of your body, including:

• Scarlet fever, a red rash that can be tiny pin pricks that are hard to see or intense redness on the body that gives it its name

• Rheumatic fever, which can damage the heart, brain, and joints

• A kidney disease called glomerulonephritis

• Poststreptococcal reactive arthritis, which is inflammation in your joints

Another rare complication that is not well-understood is a condition called PANDAS, which stands for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. It usually involves developing the tics and habits of obsessive compulsive disorder (OCD) after a strep infection. Symptoms of OCD can worsen after a strep infection, too.

Guttate psoriasis, a skin condition in which tear drop scales appear on the surface of the skin. They may be red or silver in color and can be itchy.

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Angina: causes, symptoms, treatment In other cases, when diagnosing a disease, the following pathogens are detected:

• staphylococci;
• adenovirus;
• fungi of the genus Candida;
• Coxsackie virus group A.

The main mode of entry of microbes is airborne, however, it is also possible to become infected from a person infected with sore throat when using common household products. Getting an infection and settling it on the tonsils does not always lead to the development of a sore throat. The action of microbes is activated under the influence of provoking factors: hypothermia, sudden changes in ambient temperature, reduced immunity.

Stimulate the development of the disease and some irritants that regularly enter the throat: dust, smoke, pollen, wool. With frequent cases of development of pathologies of the nasopharynx, which can be caused by the growth of adenoids or other diseases, the likelihood of getting a sore throat increases.

When purulent inflammation spreads to the surrounding tissues, which was initially localized in the paranasal sinuses, the infection will affect the entire nasopharynx, which will also lead to tonsillitis.

Symptoms of the disease

Depending on the form of the disease, the type of pathogen and the degree of angina, the general clinical symptoms will differ:

• Catarrhal. With this form of angina, the infection spreads to the mucous membrane of the tonsils. The main symptoms are: sore throat, which reaches its maximum strength during swallowing, redness and swelling of the tonsils. Against the background of the inflammatory process, an increase in temperature is observed.
• Follicular. With angina, not only the mucous membrane is affected, but also the lymphoid follicles. The primary symptom is sore throat, which begins acutely and is accompanied by a sharp rise in temperature to high levels. A person feels weakness, aching muscles and joints, headaches. Festering follicles 1-3 mm in size appear on the tonsils, which open on the second or fourth day.
• Lacunar tonsillitis, which is characterized by a deep degree of damage to the tonsils, accompanied by an accumulation of pus in the lacunae. The tonsils become bright red in color, a yellow-white coating is clearly visible on them. Soreness in the throat is accompanied by general intoxication of the body.
• Necrotic angina is quite rare and is characterized by the presence of necrotic areas.

The onset of symptoms begins after the end of the incubation period. Against the background of elevated temperature, febrile convulsions can occur – severe muscle tension, followed by shudders and twitches.

Diagnosis of angina

The success of treatment will depend on timely and competent diagnosis. The first stage of the examination is an examination of the condition of the patient’s pharynx, in which the attending physician will assess the main signs of the disease: the degree of enlargement of the tonsils and the presence or absence of purulent plaque. It is also necessary to assess the degree of enlargement of the lymph nodes in the ears, neck and neck.

Blood tests will allow you to determine the degree of increase in leukocytes and ESR, characteristic of bacterial tonsillitis. With viral sore throat, the level of leukocytes remains within the normal range or slightly decreases, the erythrocyte sedimentation rate increases slightly.

To determine the causative agent of the disease in the laboratory, an examination of mucus cultures from the oropharynx is carried out. This is important for determining the class of the disease and the competent prescription of drugs for the treatment of angina. For complicated or especially acute symptoms, the attending physician may prescribe an ultrasound of the neck.

Treatment for angina

The patient is admitted to the infectious disease department only in complicated cases. Most often, angina can be treated on an outpatient basis. The method of treatment consists not only in the elimination of common signs of angina, but also in the impact on the causative agent of the disease. The patient is prescribed:

• Regular gargling with saline solution or special antibacterial agents. During treatment, it is necessary to act on the deep parts of the pharynx, therefore, when rinsing, it is recommended to tilt your head back.
• Antibacterial and analgesic local preparations: tablets, sprays, lozenges.
• Treat with antipyretics if needed.
• Antibiotics given only after evaluating the results of laboratory tests of blood and smears. Antibacterial drugs may have varying degrees of sensitivity to a particular group of pathogenic microorganisms. When treating a bacterial infection, antibiotics of the penicillin group, macrolides, or cephalosporins may be prescribed.

During the treatment of angina, the patient should be given bed rest. It is recommended to use sparing, non-irritating food for the throat, mainly vegetable and dairy. Due to the high degree of spread of angina, a sick person should use separate personal hygiene products and utensils, limit contact with others.

Remember to consult a doctor at the first sign of illness. Ignoring the symptoms of a sore throat or a poorly treated disease can provoke complications, as well as contribute to the development of a chronic latent form, which will turn into an acute phase when the immune system is weakened.

Preventive measures include increasing the body’s defenses by taking vitamin complexes and a balanced diet, daily walks in the fresh air, eliminating irritants, responding quickly to characteristic symptoms, and limiting contact with infected people.

Angina (acute tonsillitis): features, classification, symptoms

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Angina (acute tonsillitis) is an infectious and inflammatory process affecting one or more tonsils of the peripharyngeal ring. In most cases, the palatine tonsils become inflamed. The disease can have severe symptoms with fever, severe fever and chills, severe hyperemia of the palatine tonsils, pain when swallowing, the appearance of purulent plaque and an increase in regional lymph nodes. Or proceed without pronounced characteristic symptoms.

Sore throat symptoms

Species

Causes

Complications

Angina or acute tonsillitis have a pronounced clinical picture. The incubation period lasts from 12 to 48 hours, after which clinical signs appear.

• Rise in body temperature (above 39°C, rarely 37-38°C). With angina, high body temperature is difficult to lower with the help of antipyretics.
• Signs of intoxication – body aches and weakness, headache, chills, dizziness, pain in the chest and heart area.
• Pain and sensation of a lump in the throat. Pain when swallowing.
• Hoarseness of voice.
• Inflammation of regional lymph nodes.

Examination reveals edema and hyperemia of the palatine tonsils. Depending on the type of inflammation, a purulent plaque forms on the lacunae or all tonsils.

In some cases, the symptoms of the disease may not be pronounced. The temperature can be kept within subfebrile or slightly elevated, against the background of unpleasant and painful sensations in the throat.

Inflammatory pathology of the tonsils varies:

• according to the type of pathogen, it can be bacterial, viral or fungal in nature;
• according to the nature of the course – acute or chronic;
• according to the clinical picture – catarrhal, follicular or lacunar.

Angina can be primary (simple), arising from the penetration of a bacterial infection, secondary, occurring against the background of other diseases of the body, as well as specific, caused by the action of a specific agent.

The peripharyngeal ring is an accumulation of lymphoid tissue, which is an important peripheral organ of the body’s immune system. Pathogenic microorganisms that enter the body with food and water are retained in the oral or nasal cavity precisely by the tonsils of the peripharyngeal ring. As a result of the struggle between the body and the infectious agent, a local reaction of the tonsils occurs, which is expressed in increased production of lymphocytes and can lead to tissue inflammation.

Inflammation of the tonsils can also be caused by an internal infection of the body, namely diseases of the oral cavity or ENT organs: caries, sinusitis, rhinitis, otitis media, etc. When the body’s immune defenses are weakened due to illness or hypothermia, the opportunistic microflora found in the growth or nasal cavity can provoke acute inflammation of the palatine tonsils. The factors provoking pathology are bad habits (smoking and alcohol abuse), diseases of the gastrointestinal tract, work in harmful working conditions, and malnutrition.

The risk group for the disease includes pregnant women, the elderly and children, as well as people with chronic immune system damage.

Angina is dangerous for its complications, which can be early, ie. arising immediately after inflammation of the tonsils or delayed, which appear 3-4 weeks after purulent inflammation. Complications can be single (affect one organ), or multiple and affect several organs.

Early complications of angina are otitis media, lymphadenitis, sinusitis, sinusitis, laryngeal edema, tonsil abscess, etc. Delayed inflammation provokes diseases of the heart muscle (rheumatism of the heart muscle, myocarditis, pericarditis), joint pathologies (rheumatism, arthritis), kidney disease (glomerumetritis, pyelonephritis, renal failure).

Diagnosis

The disease is detected during a clinical examination of the patient by an otorhinolaryngologist during pharyngoscopy. Additionally, clinical blood tests are carried out, as well as a bacteriological examination of a throat swab to identify the causative agent of the disease and determine its sensitivity to antibiotics.

Treatment of angina at the Gaide Clinic

In most cases, treatment is carried out on an outpatient basis. Patients are shown bed rest, warm plentiful drink, food should be light and liquid. Treatment, depending on the type of angina, includes antibiotic therapy, antiviral drugs, and local symptomatic treatment. Additionally, tonsils are irrigated with anti-inflammatory drugs, gargling with herbal decoctions and antiseptic solutions. To reduce swelling and symptoms of intoxication, antihistamines are indicated. The course of treatment is 5-10 days.

Medical centers “Gaide” provide qualified assistance for any diseases of the ENT organs in patients of all age categories. The clinics are equipped with modern diagnostic equipment for diagnosing ENT diseases, as well as a modern diagnostic laboratory at the service of patients.

Our otorhinolaryngologists are highly experienced in diagnosing and treating various diseases of the ear, nose and throat in adults and children, both conservatively and surgically. When the first symptoms of angina or other pathologies appear, do not delay a visit to the doctor and seek qualified help at the Gaide medical centers.