Sore throat is a common chief complaint prompting a visit to a healthcare provider. At SUMC patients often state’ I think I have Strep’ or request a ‘Strep test’. ‘Strep throat’ is a bacterial infection of the pharynx and tonsils caused by Streptococcal pyogenes or group A beta- hemolytic Streptococcus. It is the most common bacterial infection causing tonsillopharyngitis. However , it causes only 15-30% of pharyngitis in patients 5-15 years of age and only 10% in adults. The most common etiology for pharyngitis is viral for which antibiotics are not indicated.

SYMPTONS and SIGNS: Patients present with multiple symptoms including fever, chills, sore throat, headache, swollen glands, difficulty or painful swallowing, and rash( Scarlet fever) . Pediatric patients often present with earache, abdominal pain, nausea and vomiting, and body aches. Physical exam is noted for temperature > 101.0, erythema and swelling of the pharynx and tonsils, exudate( white pus patches), and cervical lymphadenopathy.

TESTING: The Rapid Strep test performed in the office is 85-93% sensitive in detecting the Streptococcal antigen. If the test is negative and the clinician suspects Streptococcal pharyngitis, a throat culture may be obtained.

TREATMENT: The preferred antibiotic is amoxicillin or penicillin for 10 days. A cephalosporin antibiotic( with caution), erythromycin or azithromycin may be prescribed for patients with a penicillin allergy. Patients are contagious up to 48 hours on the antibiotic. Although the patient’s symptoms will improve after several doses on the antibiotic, complete the full course.

PREVENTION: The infection is highly contagious and spreads by close contact through secretions, air droplets, shared utensils, toothbrushes, etc. The incubation period is 2-4 days and patients should remain somewhat isolated for 48 hours on antibiotics. Strict hand- washing is also paramount.

HOME REMEDIES: Gargling with warm salt water, lozenges, fluids, Tylenol or Advil will ease the symptoms.

COMPLICATIONS: Untreated Streptococcal pharyngitis can cause Scarlet fever, Rheumatic fever, peritonsillar or retropharyngeal abscess, glomerulonephritis, toxic shock syndrome, otitis media and pneumonia.

So when should a patient seek medical consultation for a ‘sore throat’? The sore throat or pharyngitis is most likely viral in etiology if associated with rhinorrhea (runny nose) or cough. Seek medical attention for a persistent fever, difficulty or painful swallowing, swollen glands or rash. At SUMC a Rapid Strep test will confirm the diagnosis, and an antibiotic will be prescribed hastening your recovery.

*Have a medical question you want to ask Dr. Kot?  Email drkot@kdhamptons.com and look for his upcoming Q + A posts.

*If you need urgent care, visit us at:
Southampton Urgent Medical Care (SUMC)
609 Hampton Road
Southampton, NY
631.204.9600 phone