Strep Throat (GAS) (cont.)
John Mersch, MD, FAAP
Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Steven Doerr, MD
Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
In this Article
- Strep throat facts
- What is strep throat and what causes strep throat?
- What are the signs and symptoms of strep throat?
- Are the signs and symptoms of strep throat different in various age groups?
- Is strep throat contagious?
- How is the diagnosis of strep throat established?
- What are home remedies, OTC, and medical treatments for strep throat?
- What are the potential complications of strep throat?
- How can I prevent contracting strep throat?
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- Take the Strep Throat Infection Quiz!
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- Strep Throat (Streptococcal) Infection FAQs
What are the signs and symptoms of strep throat?
Signs of strep throat are not unique - indeed many viral infections (which cause the large majority of sore throats) can have identical signs and symptoms as a GAS infection. Typically, an older child and adolescent will have several core symptoms:
- Fever (generally 102 F [38.88 C] and higher)
- Sore throat (may vary from mild to moderate in severity)
- Upset stomach with nausea occasionally severe enough to cause mild vomiting
Of note is the fact that runny nose, cough, hoarse voice, muscle aches, diarrhea and oral blisters are generally not seen with a laboratory confirmed strep throat infection. These latter symptoms are more commonly indicative of a sore throat caused by a virus.
Physical examination with a strep throat infection will commonly demonstrate:
- Redness of the soft palate, uvula (the "punching bag" structure hanging from the back of the soft palate) and tonsils
- A purulent discharge on the tonsils (exudate)
- Petechiae (1-2 mm bright red "dots" which represent ruptured capillaries) scattered on the soft palate
- Enlarged and tender neck lymph nodes (also known as lymph glands), and occasionally
- A diffuse rash over the torso and groin region. The classic description of this rash is that of "goose bumps on a moderate sunburn."
The presence of a strep infection and this specific rash is termed scarlet fever. Such a diagnosis does not imply a more severe GAS infection or imply any change in prognosis or management. The rash is not contagious. It is important to note that while most patients with strep throat will experience these signs and symptoms, not all will necessarily be present in each individual.
Are the signs and symptoms of strep throat different in various age groups?
The information listed above is seen in those most likely to have a strep throat infection - individuals that are older children and teenagers. However, other age groups may experience a different constellation of findings with a strep throat infection.
- Infants: more commonly have a thick purulent nasal discharge, low grade fever (< 101 F [38.33 C]), reduction in appetite and fussiness.
- Toddlers: children from one to three years of age may complain of a sore throat, have pain with swallowing and subsequently a limited appetite, and swollen lymph nodes (lymph glands) beneath the mandible (lower jaw bone).
- Adults: strep throat may have milder symptoms and thus may not prompt a medical evaluation unless an exposure history to strep throat is known.
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