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Group A Streptococcal Infections - Strep Throat

Group A Streptococcal Infections - Strep Throat Loading image. Please wait...

Group A streptococcal infections are caused by group A streptococcus, a bacterium responsible for a variety of health problems. These infections can range from mild skin infection or sore throat to invasive, life-threatening conditions such as toxic shock syndrome and necrotizing fasciitis. Most people are familiar with strep throat, which along with minor skin infection, is the most common form of the disease. Experts estimate that more than 10 million mild infections like these occur every year.

In addition to strep throat and superficial skin infections, group A strep bacteria can cause infections in tissues at specific body sites, including lungs, bones, spinal cord, and the abdominal cavity.

What is strep throat and what are the symptoms?
Your doctor may call it acute streptococcal pharyngitis. People with strep throat infections have a red and painful sore throat with white patches on their tonsils. A person may also have swollen lymph nodes in the neck, run a fever, and have a headache. Nausea, vomiting, and abdominal pain can occur but are more common in children than in adults.

How does Group A strep spread to others?
Group A strep infections can spread from person to person by direct contact with saliva or nasal discharge. Most people do not get group A strep infections from casual contact with others, but a crowded environment like a dormitory, school, or an institutional setting can make it easier for the bacteria to spread. There have also been reports of contaminated food, especially milk and milk products, causing infection. A person becomes sick within 3 days after being exposed to the germ. Once people become infected, they can pass the infection to others for up to 2 to 3 weeks even if they don't have symptoms. After 24 hours of antibiotic treatment, a person will no longer spread the bacteria to others.

How is strep throat diagnosed?
Your doctor or other health care worker will take a sample from your throat. This will be used for a culture or a rapid strep test, which only takes 10 to 20 minutes. If the result of the rapid test is negative, your doctor may do a follow-up culture to confirm the results, which takes 24 to 48 hours. If the culture test is also negative, your doctor may suspect you do not have strep, but rather another type of infection. The results of these throat cultures will affect what your doctor decides to be the best treatment. Most sore throats are caused by viral infections, however, and antibiotics are useless against them.

What is the treatment for strep throat?
Your doctor or other health care worker will take a sample from your throat. This will be used for a culture or a rapid strep test, which only takes 10 to 20 minutes. If the result of the rapid test is negative, your doctor may do a follow-up culture to confirm the results, which takes 24 to 48 hours. If the culture test is also negative, your doctor may suspect you do not have strep, but rather another type of infection. The results of these throat cultures will affect what your doctor decides to be the best treatment. Most sore throats are caused by viral infections, however, and antibiotics are useless against them.

Penicillin is considered the medicine of choice for treating strep throat because it has been proven to be effective, safe, and inexpensive. Your doctor may have you take pills for 10 days or give you a shot. Doctors often prefer to give amoxicillin to children with strep throat. If you are allergic to penicillin there are other antibiotics your doctor can give you to clear up the illness. During treatment, you may start to feel better within 4 days. This can happen even without treatment. Still it is very important to finish all the medicine in order to prevent complications.

What are the complications of strep throat?
Untreated group A strep infection can result in rheumatic fever and post-streptococcal glomerulonephritis (PSGN). Rheumatic fever develops about 18 days after a bout of strep throat and causes joint pain and heart disease. It can be followed months later by a jerky movement disorder called Sydenham's chorea. PSGN is an inflammation of the kidneys that may follow an untreated strep throat but more often comes after a strep skin infection. Both disorders are rarely seen in the United States.

Source: National Institute of Allergy and Infectious Diseases
August 2000.



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