Streptococcal Pharyngitis: Symptoms, Causes & Treatment

Strep throat is a bacterial infection of the throat and tonsils, caused by bacteria called group A streptococcus. It is among the most common causes of bacterial sore throat, especially among children and school students aged five to fifteen, and spreads through respiratory droplets when coughing, sneezing, or sharing utensils. It is very important to know that most cases of sore throat are viral, not bacterial, and these viral ones do not need an antibiotic.

Strep throat is characterized by a set of signs that help distinguish it from viral: sudden severe throat pain that increases on swallowing, fever, swollen and red tonsils that may have white spots or pus, swollen and painful lymph glands in the neck, and sometimes headache, abdominal pain, and nausea (especially in children). Importantly, cough, runny nose, and hoarseness are often absent in strep, and their presence makes a viral cause more likely. But the diagnosis cannot be confirmed by symptoms alone, so a rapid throat test or culture is done to confirm the bacteria before prescribing the antibiotic.

The importance of diagnosing and treating strep throat is not only relieving symptoms but preventing its complications, which may be serious if left untreated, foremost rheumatic fever that may harm the heart valves, and kidney inflammation. Therefore, once the diagnosis is confirmed, a suitable antibiotic is prescribed whose full dose must be completed even after symptoms improve. Drinking fluids, rest, gargling with warm salt water, and painkillers and fever reducers help relieve symptoms. The patient usually becomes non-contagious after a day or two of starting the antibiotic. Emphasizing not using antibiotics unnecessarily is important, because giving them for a viral sore throat does not help and contributes to antibiotic resistance.

• Sudden severe throat pain that increases on swallowing.
• Fever and swollen, red tonsils with white spots sometimes.
• Swollen and painful neck lymph glands.
• Absence of cough and runny nose often (distinguishing it from viral).

• Infection with group A streptococcus bacteria.
• Spread through respiratory droplets and sharing utensils.
• More common in children and school students.

• Clinical examination of the throat and neck.
• A rapid strep antigen test or throat culture to confirm the bacteria.
• Not prescribing an antibiotic without confirming the diagnosis.

When strep is confirmed

• A suitable antibiotic whose full dose must be completed even after symptoms improve.

Symptom relief

• Fluids, rest, and gargling with warm salt water.
• Painkillers and fever reducers.

The patient usually becomes non-contagious after a day or two of the antibiotic. Antibiotics are not used for viral sore throat. This content is educational and does not replace medical advice.

• Rheumatic fever that may harm the heart valves (when untreated).
• Kidney inflammation.
• An abscess around the tonsils and spread of infection.

• Hand washing and avoiding sharing utensils and cups.
• Covering the mouth when coughing and sneezing.
• Staying home until a day after starting the antibiotic to reduce spread.