Strep throat is a bacterial infection involving the back of the throat and tonsils. The classic presentation is the onset of body aches, headache and a severe sore throat with clinical findings of fever, swollen lymph nodes and tonsil exudates. A fine sand paper red rash or strep odor also confirm a strep infection. Strep prefers the throat and usually spares the ears, sinus, nose and chest, although there are always exceptions.
Group A beta hemolytic streptococcus is the bacteria that causes the most agressive infections, however, other groups of strep can cause similar symptoms. The rapid test in the office only finds the Group A strains. This expalins why some patients with negative strep screens still respond to antibiotics. Throat cultures are a more accurate test, but results are delayed for several days.
Antibiotics are used to prevent complications of strep infections — peritonsilar abscess and Rheumatic fever. I believe antibiotics shorten the duration and decrease the severity of symptoms, but this has been difficult to confirm in research studies.
Current best practices protocols recommend using antibiotics in only confirmed cases of Strep infections — by a rapid strep test or culture, waiting for results before starting treatment.
HMC Physicians treat patients on an individual basis. Patients with classic symptoms or a positive rapid strep test are treated. Those with atypical presentations and severe sore throats are treated pending culture results. Patients with mild symptoms can be treated, if confirmed, after culture results are available.
