One of our more common visits is for possible strep throat. This is a term many people use but not everyone understands. Streptococcus is a bacteria which has many types or strains. The type that can make you have strep throat is from a strain called Group A Beta Hemolytic Strep. You may have heard of Group B Strep. This is a different strain that can infect newborns as it resides in the birth canal.
Strep Throat has a tendency to occur in school age children between about 4 and 11 years of age. This doesn't mean it does not occur in very young and older children and adults, it is just much less common in these age groups. It is a common throat infection which is spread by saliva and respiratory secretions. Symptoms usually include an abrupt onset of a sore throat, fever, sometimes abdominal complaints, vomiting, headache and neck pain can occur. It is notable that COLD SYMPTOMS (Cough, Runny Nose) DO NOT USUALLY ACCOMPANY STREP THROAT. If you or your child has a sore throat accompanied by a cold, it is most likely due to another infection, usually a viral infection.
Strep Throat is treated easily with penicillin (we often use Amoxicillin because of the taste of liquid penicillin is pretty bad), or other medications if allergies to penicillin occur.
The main reason to treat strep throat is ease symptoms and make you more comfortable and to avoid rare but serious complications like acute rheumatic fever. Acute Rheumatic Fever is different from Scarlet Fever and often confused. Acute Rheumatic Fever is a serious illness which involves possible cardiac complications. Scarlet Fever is a variation of strep throat which involves a rash and is usually just a part of the infection, not a complication.
Confusing aspects to the diagnosis and treatment of strep is why not just culture everyone's throat who complains of a sore throat. The reason is that a certain percentage of the population carries strep throat innocently in their throats and may have a false positive throat culture. Being a strep carrier is a benign thing and these people do not need to be treated with antibiotics. If we cultured people who are asymptomatic for strep throat, these people would receive unnecessary antibiotics.
People often worry if strep is not "caught" early. There are studies which show that the bacteria is less likely to come back if a patient is given antibiotics several days into the illness vs right away. Rapid Strep tests are pretty accurate but not perfect. This is why we send a backup throat culture to the lab to make sure your child does not have strep. It is okay if the child is treated after a couple of days, and maybe even better for the immune response.
Over 90% of our throat cultures are negative for strep throat. To avoid unnecessary worry, remember the ages which are more common, and symptoms to watch.