What You Need to Know About Strep Throat

Our children give us so many gifts through our lives, including things like hand foot and mouth disease (see my article on this previously) and multiple cold viruses.

Recently, my daughter Juliette gave me the gift of strep throat, which I haven’t had the pleasure of experiencing since I was a teenager.

I noticed I wasn’t feeling great, and by the end of the day had a terrible sore throat. Like swallowing-razor-blades painful, and my neck was sore to the touch. I thought maybe it was just a little post-nasal drip causing the pain, but ran a strep test just in case. And there it was: positive!

I think most people know strep is important to treat with antibiotics, but let’s talk about why.

First of all, strep throat is common — more than 3 million cases a year! It’s most common in kids ages 6-18 but truly can occur in anyone at any age.

The treatment of choice is the same as it has been for the past more than 80 years — good ol’ penicillin (yes, there are other options for people who are allergic). And unlike many other bacteria, there has never been a report of strep being resistant to penicillin.

Rarely, strep throat can come along with a sandpapery rash, and when this happens, it’s called scarlet fever.

Even more rarely, but the most feared complication of untreated strep throat, is rheumatic fever. This typically occurs one to five weeks after an untreated or under-treated strep infection and can cause inflammation and permanent damage to the heart. This is why you should always finish the prescription given to you and not “save some for later” when you start to feel better!

But not all sore throats are strep. Viruses are still the most common cause of a sore throat in children and adults. Strep is the source in only 20-30 percent of sore throats in kids and 5-15 percent of adults (per the CDC). So how can we tell? It does help to have the rapid strep tests in our offices, but there are some criteria that we look for clinically that help guide us on how likely it is.

First of all, swollen, red tonsils with pustules (white spots) are a clue, as are swollen, tender lymph nodes on the front of the neck, fevers, and absence of a cough. If all of these things are there, the chance of strep is more than 50 percent, so we will typically treat.

Now, in my family’s case, Juliette and I have strep throat and are taking antibiotics (actually this is the first time she has needed antibiotics ever — age 4, not bad!) but my husband and Scarlett (our 6-month-old) don’t have any symptoms. So we will wait and see. It’s VERY uncommon for kids under 3 to get strep, and because the reason it is so important to treat strep is to prevent Rheumatic fever, and this is almost unheard of in kids under 3, we don’t worry about it nearly as much.

My husband has about a 25 percent chance of getting it, but it’s not necessarily recommended to treat him unless symptoms develop.

So there you have it, everything you wanted to know about strep throat in a nutshell!

About Dr. Amanda Magrini

Amanda Magrini, MD, is a board-certified family medicine physician at Northern Nevada Medical Group’s Los Altos location in Sparks. She completed her undergraduate degree at the University of Nevada, Reno and her medical training at the University of Nevada School of Medicine. Dr. Magrini has practiced family medicine for seven years, including residency, and enjoys her specialty, because she likes taking care of the whole family, from newborns to grandparents. She likes preventative medicine, helping people take care of themselves and the relationships she is able to form with her patients. Dr. Magrini grew up in Sparks, NV and likes that it is a safe place to live with great educational opportunities and beautiful scenery. She thinks Northern Nevada is a great place to raise a family and looks forward to raising her own children here. In her spare time, she enjoys outdoor activities such as hiking, biking, camping, boating, running and traveling the world. Dr. Magrini is also very close with her family; she is married to her high school sweetheart and values spending time with him and the rest of her family. Disclosure: “The author is a licensed physician practicing with Northern Nevada Medical Group, but all opinions expressed are solely the opinions of the author and do not necessarily reflect the views of Northern Nevada Medical Group or any other affiliates of Universal Health Services, Inc.”