Strep Throat

Overview/prevalence

Group A Streptococcus pharyngitis is the most common bacterial pharyngitis in children and adolescents. The incidence peaks in the winter and early spring. 

Symptoms

The symptoms of strep pharyngitis depend on the age. 

In children under the age of 3 they do not typically exhibit the same symptoms as those over 3. Under 3 usually presents with low grade fever, nasal congestion, runny nose, and tender lymph nodes in the neck. Infants under 1 year old may have a decreased appetite, be more fussy, and a low grade fever. 

In those over the age of 3, they typically present with sudden onset of fever, headache, sore throat, abdominal pain, nausea, and sometimes vomiting. Some may also exhibit a rash. There may also be tender neck lymph nodes, swollen and red tonsils. 

Symptoms usually resolve spontaneously in 3-5 days. 

Complications

Complications of streptococcal pharyngitis include 

-rheumatic fever

-poststreptococcal glomerulonephritis 

-PANDAS (pediatric autoimmune neuropsychiatric disorders associated with 

   streptococcus)

- necrotizing fasciitis

-bacteremia

-otitis media 

-peritonsillar abscess

-sinusitis 

Diagnosis

The diagnosis of streptococcal pharyngitis is supported by a positive microbiological test, such as a throat culture, in patients with symptoms of strep pharyngitis without signs of a viral illness

Treatment

Group A Streptococcus is one of the few causes of pharyngitis that antibiotics are recommended. Treatment is recommended for anyone with symptoms who have a positive rapid antigen test or culture. 

Most people can return to school or work 12 to 24 hours after antibiotics have started, as long as there is no fever and they are feeling better. 

Prevention

Hand hygiene is the standard for preventing transmission.