From the Guidelines
Strep throat typically presents with a sudden onset of severe sore throat, pain when swallowing, fever over 101°F, red and swollen tonsils, and swollen, tender lymph nodes in the neck, and requires prompt medical attention for antibiotic treatment to prevent complications. The symptoms of strep throat can be distinguished from viral infections by the absence of cough, runny nose, hoarsiness, or conjunctivitis, as noted in the study by 1. Some common symptoms of strep throat include:
- Sudden onset of severe sore throat
- Pain when swallowing
- Fever over 101°F
- Red and swollen tonsils, sometimes with white patches or streaks of pus
- Tiny red spots on the roof of the mouth
- Swollen, tender lymph nodes in the neck
- Headache
- Body aches
- Rash
- Nausea and vomiting, particularly in children These symptoms usually appear 2-5 days after exposure to the Streptococcus bacteria, as mentioned in the study by 1. It is essential to seek medical attention promptly if you experience these symptoms, as strep throat requires antibiotic treatment, typically penicillin or amoxicillin for 10 days, to prevent complications like rheumatic fever or kidney inflammation, as recommended by the study by 1. Even if symptoms improve quickly, completing the full antibiotic course is crucial to fully eliminate the infection and prevent these serious complications. The modified Centor criteria, which include fever by history, tonsillar exudates, tender anterior cervical adenopathy, and absence of cough, can be used to determine the likelihood of a bacterial cause, as noted in the study by 1. However, the IDSA suggests that these criteria have a low positive predictive value for determining the presence of group A streptococcal infection and should be used to identify patients who have a low probability of group A streptococcal pharyngitis and do not warrant further testing, as mentioned in the study by 1. Patients who meet fewer than 3 Centor criteria do not need to be tested, but those who present with unusually severe signs and symptoms should be evaluated for rare throat infections, such as peritonsillar abscess, parapharyngeal abscess, epiglottitis, or Lemierre syndrome, as recommended by the study by 1.
From the Research
Symptoms of Strep Throat
- Sore throat
- Temperature greater than 100.4 degrees F (38 degrees C) 2
- Tonsillar exudates
- Cervical adenopathy 2, 3
- Fever
- Tonsillar exudate
- Cervical lymphadenitis 3
- Cough, which is more suggestive of a viral etiology 3
- Coryza and diarrhea, which are more common with viral pharyngitis 2
Diagnosis and Treatment
- Throat culture is considered the diagnostic standard 2
- Rapid antigen detection testing can be used to diagnose strep throat 2, 3
- Penicillin and amoxicillin are first-line antibiotics for treating strep throat 2, 3, 4, 5
- First-generation cephalosporins are recommended for patients with nonanaphylactic allergies to penicillin 3
- Antibiotics with narrow spectrums of activity are appropriate for treating strep throat 6