Strep throat: Causes, diagnosis, and treatments

Strep throat is a sore throat caused by bacteria known as Streptococcus pyogenes, or group A streptococcus.

“Sore throat” is the general term for any condition where the throat feels scratchy, tender, and possibly painful. Strep throat, however, is a sore throat caused by a specific strain of bacteria.

In this article, we will cover the causes, symptoms, diagnosis, and treatment of strep throat.

Fast facts on strep throat

Here are some key points about strep throat. More detail and supporting information is in the main article.

Strep throat is caused by group A streptococcus bacteria.

Streptococcal bacteria are extremely contagious.

Children are more susceptible than adults because their immune systems have had less experience of germs.

If the sore throat is causing difficulty in breathing, seek medical help immediately.

Diagnosis of strep throat often involves a throat swab.

What is strep throat?

Boy with strep throat
Young boy with strep throat. Note the reddened soft palate at the back of the throat.

Strep throat may also be referred to as Streptococcal pharyngitis or streptococcal sore throat; it is only ever caused by bacteria.

Streptococcal bacteria are extremely contagious and can spread through airborne droplets when a sick person sneezes or coughs.

People may also become infected by touching surfaces that an infected person had previously touched, such as a doorknob, kitchen utensils, or bathroom objects.

Most sore throats are not usually serious, and the infected person generally improves within 3-7 days without treatment.

Sore throats are more common among children and adolescents; this is because younger people’s bodies have not been exposed to as many viruses and bacteria as older people’s – they have not built up immunity to many of them.

It is not uncommon for people of any age to have a couple of bouts of sore throat in a 1-year period.

Symptoms of strep throat

The symptoms of strep throat are similar to a sore throat; these include:

Pain in the throat.

Difficulty swallowing.

Loss of appetite.

Tonsils are painful and/or swollen; sometimes with white patches and/or streaks of pus.

Very small red spots may appear on the soft part of the palate (roof of the mouth).

Nodes (lymph glands) of the neck are swollen and tender.

Fever.

Conversely, people with strep throat may sometimes have no signs or symptoms – these people might not feel ill, but they can still pass the infection onto other people.

[Doctor examining child's throat]
If symptoms have remained for more than 2 weeks, it might be time to seek medical attention.

In most cases, a sore throat is just one of the symptoms of a common cold and will resolve itself in a few days. However, you should see a doctor if:

Symptoms are still there after a couple of weeks.

Sore throats are frequent and do not respond to painkillers.

There is persistent fever – this indicates an infection that should be diagnosed and treated as soon as possible. Infections may cause breathing problems or lead to complications.

There are breathing difficulties (urgently).

Swallowing saliva or fluids is difficult.

Drooling becomes common.

The immune system is weak – for instance with HIV/AIDS, diabetes, or anyone receiving chemotherapy, radiotherapy, steroids, or immunosuppressant medications.

Urine becomes Cola-colored – this means the streptococcus bacteria has infected the kidneys.

Diagnosis of strep throat

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