STREP THROAT · PDF fileGargle with warm salt water: ... Avoid irritants: cigarette smoke, fumes (paint, cleaning products) Throat losenges: provides temporary relief of sore throat

STREP THROATSTREPTOCOCCUS PYOGENES

WHAT IS STREP THROAT?

A contagious disease caused by infection with streptococcal bacteria

Specific bacteria= Group A Streptococcus (GAS) bacteria: streptococcus pyogenes

This bacteria are often found in the throat or on the skin and are responsible for other illnesses as well as impetigo (skin infection)

WHAT IS STREP THROAT (cont’d)

It is the most common cause of sore throat in school aged children and teens

Causes inflammation and swelling of the mucus membranes lining the back of the throat and tonsils

Some individuals may carry Group A Streptococcus in the throat or on the skin and not have any signs or symptoms

SIGNS AND SYMPTOMS:

Throat pain that usually comes on quickly

Painful swallowing

Red and swollen tonsils sometimes with white patches or streaks of pus

Tiny red spots on the soft or hard palate of the mouth

Swollen, tender lymph nodes

Fever, headache, rash

Nausea or vomiting

Body aches

VIRAL OR STREP?

Many of these signs and symptoms could be a viral infection or other illness.

VIRAL OR STREP?

VIRAL Sore throat is often the first sign of a cold Sore throat from a cold often gets better

or goes away within 1-2 days Accompanied by congestion, runny

nose, red or watery eyes, cough and sneezing

Other causes of sore throat are irritants in the air, allergies or dry air

Antibiotics are not effective in treating viral illness

STREP Sore throat is more severe and persists

Painful inflammation or infection of the tonsils, the tissue masses located at the back of the throat

Treated with antibiotics

WHEN TO SEE A DOCTOR:

A sore throat that is accompanied by tender, swollen lymph glands

A sore throat that lasts longer than 48hrs

A fever higher than 101F (38.3 C) in older children or fever that lasts longer than 48hrs

Sore throat with a rash

Problems breathing or swallowing

HOW DO YOU GET IT?

Streptococcal bacteria are highly contagious

It spreads through airborne droplets (coughing, sneezes, shared food/drinks)

It also spreads through infected surfaces (door knobs, tables) and transfer them to your nose/mouth/eyes

Spreads when groups of people are in close contact

Tends to circulate in the late fall and early spring

CONTAGIOUS PERIOD:

Contagious for about 2-3 weeks in people that do not take antibiotics

Spreads via -direct contact (person-person)- mucus droplets

-indirect contact (kissing, sharing utensils and drinking cups)

Incubation period: 1-5 days after exposure to the bacteria

No longer contagious 24 hours after antibiotics have been started

DIAGNOSIS:

Physical exam looking for signs and symptoms of strep throat

Rapid Antigen Test

Throat Culture

RAPID ANTIGEN TEST:

Throat swab that can detect strep bacteria in minutes by looking for substances (antigens) in the throat

A positive test response occurs when a reaction occurs between a protein on the surface of the strep bacteria and chemicals in the test material

Either living or dead strep bacteria will produce a positive reaction Most rapid tests have a sensitivity of 95% 98% of positive tests correctly indicate the presence specifically of Group

A Streptococcus bacteria 2% false positive = similarity between surface proteins found on strep

bacteria

THROAT CULTURE:

The most traditional test

Sterile swab rubbed over back of throat and tonsils to get a sample of secretions

Sample is cultured in a lab looking for presence of the bacteria

LIMITATIONS:

Rapid Antigen Test 5/100 people with strep throat will be

missed, therefore all negative swab specimens should be sent for culture to confirm the absence of strep bacteria

Responds only to the presence of the streptococcal bacteria (Group A) responsible for strep throat- other bacteria and viral causes are not detected

Cost of test kit Accessibility

Throat Swab Can take as long as 2 days to get

culture results= possible delay in starting antibiotics

Access to a lab

TREATMENT:

ANTIBIOTICS (Penicillin, Amoxicillin, Cephalexin)

Reduce the duration and severity of symptoms

Reduce the risk of complication and reduce spread of infection

Improvement seen in 1-2 days

An individual is no longer contagious after 24 hours after beginning antibiotics

Entire dose of antibiotics must be completed Antibiotics will not help if a sore throat is caused by a virus

COMPLICATIONS:

Strep bacteria may spread causing infections in: Tonsils

Sinuses

Skin

Blood

Middle ear (Otitis media)

Kidneys (Glomerulonephritis)

Brain (meningitis)

SCARLET FEVER:

Bacterial illness that develops is some people who have strep throat Features a bright red rash that covers most of the body If left untreated can result in more serious conditions that affect the

heart, kidneys and other parts of the bodySYMPTOMS: Red rash: looks like a sunburn and feels like sandpaper Red lines: folds of skin around the groin, armpits, elbows, knees and

neck become a deeper red than the rash Flushed face: Strawberry tongue: looks red and bumpy and often covered with a

white coating early in the disease

RHEUMATIC FEVER:

A serious complication of strep throat if left untreated or inadequately treated by antibiotics

Causes a persistent immune response from the body that triggers the immune system to mistakenly attack other organs in the body including the joints and heart vales causing arthritis and potential heart failure

POST-STREPTOCOCCAL GLOMEULPNEPHRITIS (PSGN)

Characterized by the sudden appearance of hematuria, proteinuria and red blood cell casts in the urine, edema and hypertension with or without oliguria

Develops 10-14 days after strep throat infection

Children less than 7 years old are at increased risk of developing PSGN after an episode of strep throat

Typically resolves spontaneously after a few weeks and usually does not lead to permanent kidney damage

SELF MANAGEMENT:

Get plenty of rest - sleep helps the body fight infection

Drink plenty of water - keeping a sore throat lubricated and moist eases swallowing and helps prevent dehydration

Eat soft and cold foods: easy-to-swallow foods are more soothing (broths, applesauce, popsicles, smoothies)

Gargle with warm salt water: ¼ teaspoon salt to 8ozs of warm water- helps relieve throat pain

SELF MANAGEMENT:

Use a humidifier: cool mist moisture eases discomfort

Avoid irritants: cigarette smoke, fumes (paint, cleaning products)

Throat losenges: provides temporary relief of sore throat (not recommended for young children)

Over-the-counter (OTC) pain medications: Tylenol and advil-reduce fever and provide pain control

PREVENTION:

Hand hygiene is the best way to prevent spread of infection

Do not share personal items (drinking glasses, utensils)

Cover your mouth

Clean surfaces

QUESTIONS TO DISCUSS:

If awaiting throat culture results, would you immediately start antibiotics based on physical examination or after getting a positive throat culture result?