Strep throat

Strep throat
Strep throat is the name given to the infection of the throat caused by bacteria; particularly group A streptococcus species bacteria. It is characterised by swelling of tonsils and throat region, pain and irritation in throat. Regional lymph nodes may show enlargement, and appear as lump in the neck region.

Causes:

  • It is caused by group A beta-haemolytic streptococcus species.
  • It is a contagious infection, i.e. spreads from one person to another by direct saliva droplet inhalation, touching articles, coughing and sneezing of the affected person and sharing of the same utensils with an affected person.

Symptoms:

  • Typical symptoms include headache, body pain, fever, malaise and nausea.
  • In some cases petechiae on the palate can be seen. If present, they are the characteristic sign of a strep throat. Petechiae are small pinpoint haemorrhages, which appear as red spots.
  • Throat related symptoms include cough, pain and irritation in throat.
  • Rheumatic fever may also be present.

The incubation period is one to three days after the exposure.

Diagnosis:

  • The diagnosis is usually done by checking the signs and symptoms and recording a proper patient history.
  • The presence of eye inflammation, mouth ulcers, runny nose and absence of fever indicates the presence of some other disease but not strep throat.
  • A bacterial culture test may also be performed to confirm the presence of bacteria in sputum sample. Culture test is the gold standard for diagnosis of the infection. Sample is collected by coughing or throat swabs, and cultured for the presence of bacteria.
  • A newer method which provides quick diagnosis is the rapid strep test, but is has a lower sensitivity of 70%.

Treatment:

The infection usually resolves within a few days, however, the period of illness can be reduced by taking some medications.

  • Antibiotics: penicillin or amoxicillin is the drug of choice in the treatment of strep throat. In case of penicillin resistance, erythromycin or clindamycin can be prescribed. Antibiotics are generally given to avoid complications like retropharyngeal abscess or rheumatic fever, and it also reduces the chances of spreading of infection.
  • Analgesics: painkillers are given to reduce the discomfort and pain in throat. Non-steroidal anti-inflammatory drugs, like ibuprofen, and paracetamol are generally given. Viscous lidocaine can also be given locally. In children and young adults, aspirin is contraindicated because of the risk of developing Reye’ syndrome, which has numerous hazardous effects on various vital organs.
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