What is Strep Throat?
“Strep” is short for streptococcus which is the name of a bacteria that causes throat infections. Strep is a common bacterial infection that afflicts adults as well as children. During the winter months, it is seen most frequently but this past summer, I diagnosed numerous cases of streptococcal pharyngitis.
Most persons with strep throat are miserable. Their eyes are droopy. Their shoulders are slouched. Very few words are spoken by patients who have strep throat.
Quick care or ER?
Strep throat can easily be seen in a Quickcare clinic.
A trip to the ER is needed if you have :
- Shortness of breath
- Severe Pain
- Cannot swallow your own saliva
What will your doctor ask?
Your doctor will ask of symptoms. Remember, a symptom is your description of your pains to your doctor. It is your story
Strep throat symptoms typically are throat pain, fever, and generalized myalgia.
Symptoms of Strep Throat also include swollen neck glands.
Your doctor will want to know:
- When did your symptoms start?
- Were you exposed to others with Strep?
- Are you able to swallow?
- Do you have any shortness of breath?
- Do you have any rashes or neck stiffness?
What will your doctor look for?
Your doctor will look for signs. Remember, a sign is an objective finding discovered during the physicians’ examination.
What does strep throat look like?
Typically, persons will look just plain miserable. Droopy eyes. Quiet demeanor. Reluctant to talk. Just “Blah.”
Specifically, signs of Strep Throat typically include a red swollen throat. There may be pus (exudate) on the tonsils.
One unique sign is a “hot potato” voice which is muffled and strained phonation.
In terms of tests, a simple bedside rapid strep test is easy and convenient. A more specific test is a throat culture.
What is your doctor thinking?
Your doctor will create a mental list of possible reasons for your signs and symptoms. This list is called a differential diagnosis.
If a patient presents with a sore throat and fever, it could be viral illness such as mononucleosis.
In children, your doctor may consider a posterior pharyngeal abscess. One serious concern seen in adults and children is epiglottitis. This is a swelling of the epiglottis causing airway compromise. THIS MAY BE LIFE-THREATENING.
A more benign diagnosis to consider (especially in children) is mouth sores (stomatitis) or herpes angina. Another possibility is candidiasis which is fungal infection causing a white thick discharge.
What is the treatment of Strep Throat?
A Strep infection needs antibiotic treatment. Antibiotics come in many many families. I usually write for penicillin. The Penicillin family includes Amoxicillin and Augmentin. If there is an allergy to the penicillin family, then I like to use Zithromax (Azithromycin). Another effective group of antibiotics is the sulfa family which includes Bactrim. Doxycycline is great for strep throat also
I like to tell my patients to add gargles with warm salt water or apple cider vinegar. It is an old trick that still works. Via osmosis, the swelling of the tonsils will diminish. It is not curative of the bacteria but at least at will decrease the discomfort that goes along with swollen glands.
Since Strep throat is contagious, it is important to keep away from others especially the elderly and immunocompromised.
Follow the basics. Wash your hands and cover your cough.
How long will you be sick with Strep Throat?
Typically, strep throat should resolve within a week. The concern is if it turns into a more serious infection such as a peritonsillar abscess. At that point, patients have severe pain, difficulty swallowing, and, at times, difficulty breathing. To relieve the peritonsillar access, it is best to go to the ER and have it surgically incised (cut open).
One long term complication of strep throat is rheumatic fever, a diffuse inflammation involving the heart, joints, and skin.
At times, I do have to change the antibiotics if there is no improvement. That is, I may start with penicillin such as amoxicillin and then change it to Zithromax which has a broader spectrum of bacterial coverage.
I hope this helps
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