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Strep Throat! What is it, Doc?

Dear friends, TGIF! Welcome back to Dr Euan's Blog Post.


Even as our COVID case numbers rise with new clusters, thus far, our ICU and seriously ill numbers remain low. Hopefully, that can remain the case as more than 80 percent of our population is fully vaccinated.


Have you been worried by sore throat? And fearful you may have caught "STREP THROAT"? how do you tell if it is a serious infection? What treatment should you start? Well, read on!



Q: What Is Strep Throat?


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

Strep throat comes from a common bacterial group, Group A Streptococcus, also known as Streptococcus pyogenes (MedLine)

Q: What are Strep Throat Symptoms?


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 is that a virus will often cause a runny nose too.

Intra Oral photograph of a patient with Strep Throat: you can see the swollen, inflamed tonsils with the typical white exudate and patches in the throat.

With strep, the sore throat comes on quickly and is more likely to cause other symptoms, such as:

  • A fever of 38 deg C / 101 deg F or higher

  • Red, swollen tonsils

  • Painful sensation when you swallow food or drink

  • 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)

  • Loss of appetite

  • Stomach ache

  • Head ache

  • Body aches

  • Nausea, vomiting

  • Loss of appetite

  • Rash

Q: How do we confirm Strep Throat:

Your doctor will take a detailed history and ask about you or your child's symptoms. The only sure way to tell strep from viruses that also cause sore throat is with a test.


Illustration to show the Rapid Strep test being done in a child (from eMedicineHealth)


There are two kinds of tests commonly done to test for Strep Throat:

1. Rapid Strep Test: This test can identify a case in just a few minutes. The doctor will gently hold down your tongue with a depressor. Then, he/she will use a cotton swab to take a sample from the back of the throat. You will get the results in 20 minutes or less. If the test is positive, which means strep is there, the doctor will prescribe antibiotics to treat it.

If the test is negative, which means the strep bacteria could not be detected, the doctor might send the sample to a lab for a follow-up test.

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

It usually takes about 2 days to get results from a throat culture. It can confirm whether your child has strep throat or not.


Q: What are the Strep Throat Treatments and Home Care Advice?


Medications


Your GP or ENT Specialist will prescribe antibiotics to kill the bacteria that cause the infection. Most treatments last for about 10 days. The medicine can make your child's symptoms go away faster and help prevent complications.


Make sure your child takes all of the doses and completes the course of antibiotics. Stopping the medicine too early can leave some bacteria alive. This can make your child sick again. Be sure to tell the doctor if your child / teenager is allergic to any types of antibiotics.


If the strep test is negative, a virus likely caused the sore throat. Your child does not need antibiotics because these antibiotics do not work on viruses.


You can also take medications to provide relief of symptoms and to ease the pain of strep throat and lower fever including over-the-counter medications such as paracetamol (Panadol), ibuprofen or acetaminophen. Avoid giving aspirin to children or teens. It can cause a rare but dangerous condition called Reye’s syndrome.


Home Care:



Here are some simple measures you can take as you rest and recuperate at home:

  • 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. Do NOT give small pieces of candy to children younger than 4, as they may choke on these!

  • Replace your old toothbrush with a new soft toothbrush.

  • 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, to provide relief

  • Choose soft foods that are easy to swallow such as soups, apple sauce, yoghurt or oatmeal. Pass on orange juice and other drinks that have a lot of acid. They may given you a stinging sensation as you swallow.

  • Honey can help ease pain and inflammation.

  • Use a humidifier and/or saline nasal sprays to keep your airways moist, which will help you feel more comfortable.

  • Get plenty of rest so that your body can recover from the infection

Q: What are the complications I may get from Strep Throat?


Strep throat complications are rare today, mainly due to better diagnosis and treatment with timely antibiotics. Yet untreated strep 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

  • Abscess around the tonsils or behind the throat. Called a peri-tonsillar abscess, it’s a collection of pus that can be extremely painful.

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

Another rare complication that is still 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 or having symptoms of OCD worsen after a strep infection.

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


Tonsillectomy for Strep Throat in Adults


If you frequently get strep throat, your doctor might recommend removing your tonsils. This procedure is called a tonsillectomy. It can help reduce the number of strep throat cases you get. However, this does not mean that not having tonsils makes you completely immune to strep throat.


If you are worried or concerned that you / your child may have Strep Throat infection, please make an early appointment with your GP or ENT Specialist so that Early Diagnosis and Proper Treatment can be initiated and prevent any serious complications.


Meanwhile, Have a good restful weekend ahead 😊


If you are interested to find out more about STREP THROAT, please look up these references:


References:


1. Medscape [Internet]. New York (NY): WebMD, LLC. Group A Streptococcal (GAS) infections; 2017 Aug 8 [cited 2018 Apr 20]. Available from: https://emedicine​.medscape​.com/article/228936-overview

2. Diseases caused by Group A strep [Internet]. Atlanta (GA): Centers for Disease Control and Prevention. 2016 Sep 16 [cited 2018 Apr 20]. Available from: https://www​.cdc.gov/groupastrep​/diseases-public/index.html

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