Strep throat

By Mayo Clinic Staff

Symptoms

Symptoms of strep throat most often involve throat pain that comes on quickly and pain with swallowing. Strep throat also may cause scarlet fever, which causes a rash on the body.

Other symptoms of strep throat may include:

• Red and swollen tonsils, sometimes with white patches or streaks of pus.
• Tiny red spots at the back of the roof of the mouth.
• Swollen, tender lymph nodes in the neck.
• Fever and body aches.
• Headache.
• Rash.
• Upset stomach or vomiting. This happens mainly in young children.

You or your child may have many of these symptoms but not have strep throat. An infection from a virus or other illness also can cause them. With strep throat, you're not likely to have a runny nose, cough or other symptoms of a viral infection. A test for strep throat can confirm the diagnosis.

Also, some people are carriers of strep but show no symptoms. These people don't need treatment. But they can spread the infection.

Causes

Bacteria called Streptococcus pyogenes causes strep throat. The bacteria also is called group A streptococcus.

Strep throat is contagious, which means it can spread from person to person. The bacteria spread through droplets when someone with the infection coughs or sneezes. And they can spread through shared food or drinks.

Complications

Strep throat can lead to serious complications. Antibiotic treatment lowers the risk.

Inflammation

Strep infection rarely may lead to conditions that involve swelling and irritation, called inflammatory conditions. These conditions may include:

• Poststreptococcal glomerulonephritis, which causes inflammation of the kidney.
• Rheumatic fever, a serious condition that can inflame the heart, joints, nervous system and skin.
• Poststreptococcal reactive arthritis, which is inflammation of the joints.

Diagnosis

Your healthcare professional does a physical exam and looks for symptoms of strep throat. You may have one or more of these tests:

• Rapid antigen test. This test looks for bacteria on a sample taken by a swab of the throat. It can find strep bacteria in minutes. If the test is negative, meaning it doesn't show strep infection, your healthcare professional may suggest a throat culture.
• Polymerase chain reaction (PCR) test. This test also uses a swab sample from the throat.
• Throat culture. A healthcare professional takes a swab from the back of the throat and tonsils. It's not painful, but you might gag. A lab technician cultures the sample to see if bacteria grow. Results can take up to two days.

Antibiotics

An antibiotic taken by mouth within 48 hours of when strep began may keep it from lasting as long or being as bad as it would be without treatment. An antibiotic also lowers the risk of complications and makes it less likely that the infection will spread to others.

With treatment, you or your child should start to feel better in a day or two. If you don't feel better after taking antibiotics for 48 hours, call your healthcare professional.

Children who take an antibiotic, feel well and don't have a fever often can return to school or child care 24 hours after starting treatment. By that time, they're less likely to spread the infection.

Even after they feel better, children need to take all the medicine. Stopping early can lead to strep coming back and causing serious complications.

Self-care

Most often, antibiotics quickly rid the body of the bacteria that cause strep infection. In the meantime, try these tips to feel better:

• Get plenty of rest. Sleep helps the body fight infection. If you have strep throat, stay home from work if you can. Keep children who are ill at home until there's no fever, they feel well and they've taken an antibiotic for at least 24 hours.
• Drink plenty of fluids. This makes swallowing easier. It also helps prevent loss of body fluids, called dehydration.
• Eat soothing foods. Easy-to-swallow foods include broths, soups, applesauce, cooked cereal, mashed potatoes, soft fruits, yogurt and soft-cooked eggs. Puree foods in a blender to make them easier to swallow. Cold foods, such as frozen yogurt or frozen fruit pops, may soothe the throat. Ice chips also may help. Don't have spicy foods or acidic foods such as orange juice.
• Gargle with warm salt water. For older children and adults, gargling a few times a day can help ease throat pain. Mix 1/4 teaspoon (1.5 grams) of salt in 8 ounces (237 milliliters) of warm water. Tell children to spit out the liquid after gargling.
• Use honey. Honey can soothe sore throats. But don't give honey to children younger than 1 year.
• Add moisture. Use a cool-mist humidifier to mist the air to help ease discomfort. Clean the humidifier daily to keep bacteria and molds from growing. Try a saline nasal spray to help keep the inside of the nose moist.
• Stay away from irritants. Cigarette smoke can irritate a sore throat and raise the chance of getting infections such as tonsillitis. Stay away from fumes from paint or cleaning products. These also can irritate the throat and lungs.

What you can do

When you make the appointment, ask if there's anything you need to do before you go, such as fasting before a test. Make a list of:

Any symptoms and when they began. Include any that seem unlinked to the reason for your appointment.

• Key personal information, including major stresses, recent life changes and family medical history. Include the likely source of the infection, if you know it.
• All medicines, vitamins and supplements you or your child takes, including the doses.
• Questions to ask your healthcare professional.

Take along a family member or friend, if possible, to help you remember what your healthcare team says.

For strep throat, some basic questions to ask include:

• What's the likely cause of these symptoms?
• What are other possible causes?
• What tests can diagnose this?
• What treatment do you suggest?
• How soon might symptoms get better with treatment?
• How long can this spread to others? When is it safe to return to school or work?

Be sure to ask all the questions you have.

What you can do in the meantime

If you think you or your child might have a strep infection, take steps to ease symptoms and keep from spreading the infection:

• Wash hands often. Cover your mouth when you cough or sneeze. Don't share personal items.
• Gargle with 1/4 teaspoon (1.5 grams) of table salt in 8 ounces (237 milliliters) of warm water. Spit the water out.
• Rest, drink fluids, eat soft foods and take pain relievers, such as ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others).