How to Understand If You Have a Streptococcal Infection at the Throat

How to Understand If You Have Laryngitis
respiratory diseases

How to Understand If You Have a Streptococcal Infection at the Throat

How Do you Get Strep Throat. It is a contagious bacterial infection that develops in the throat. It is estimated that about 30 million cases are diagnosed each year. Although children and people with compromised immune systems are more likely to suffer than healthy adults, the infection can actually affect anyone at any age. The only way to find out for sure if you have this type of pharyngitis is to go to the doctor and undergo specific tests. However, the infection manifests symptoms that you can recognize even before scheduling an appointment with the doctor and that can make you understand if you have strep throat infection in progress.

How Do you Get Strep Throat
Evaluate the symptoms of the throat and mouth

1) Determine how severe your sore throat is.
Usually, a severe sore throat is the first sign of streptococcal pharyngitis. You can have this infection even if you experience slight discomfort, but it is usually rare that a mild pain that calms down or resolves easily is caused by the streptococcus bacteria.
Pain should not be related to actions such as speaking or swallowing.
Even the pain that you can soothe with painkillers or partially placate with liquids or cold foods can be related to this infection, but it is generally quite difficult to get rid of the pain completely without taking prescription drugs.

2) Try swallowing.
If you experience slight pain that gets worse when you swallow, you may have streptococcal tonsillitis. Pain during swallowing, which makes it difficult to ingest food or liquids, is particularly common in people who suffer from this infection.                                                                                                                                                                                                                                          14 MARCH 2018


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3) Smell your breath.
Although halitosis is not a common symptom of all patients, the infection caused by streptococcus bacteria can often cause a very bad breath due to bacterial reproduction.
Although it is quite strong, it is difficult to describe the exact smell of the breath. Some say it resembles the smell of metal or hospitals, while others compare it to the rotten meat. Regardless of the type of smell, “the pharyngitis breath” is still strong and worse than normal halitosis.
Given that “bad breath” is often a very subjective matter, this criterion is not actually a precise method for diagnosing strep throat pain, rather a fairly common feature of infection.

3) Palpate the neck glands.
Lymph nodes capture and destroy germs, so in the presence of this infection, those of the neck are usually swollen and sensitive to touch.
Although the lymph nodes are found in different parts of the body, the first to swell in general are those closest to the source of the infection. In the case of a sore throat, those that dilate are the lymph nodes above and around the throat.
Use your fingertips to gently touch the area just in front of your ears. Move your fingers in a circular motion behind the ears.
Also, check the throat area just below the chin. The most common area where the lymph nodes swell because of the throat infection is just below the jaw, about halfway between the chin and the ears. Move the fingertips forward and up towards the ears, then along the sides of the neck and below the ears.
End the check by also checking the clavicle area and repeat again on both sides.
If you notice a significant swelling in one of these areas, it means that the lymph nodes can be dilated due to streptococcal infection.

4) Check the language.
In the active phase of infection, we often notice a coating of tiny red dots on the tongue, with a thorny appearance, especially in the back of the mouth. Many people compare this coating to the outer surface of strawberries.
Such red dots may have a bright red or dark red colour and generally appear inflamed.

5) Look at the back of the throat.
Many people suffering from a streptococcal sore throat develop petechiae, ie red spots on the soft or hard palate (in the upper part of the mouth, towards the back).

6) Check the tonsils too, if you still have them.
Streptococcus infection usually tends to ignite them. In this case, they appear a brighter red or more intense than usual and are considerably enlarged. They could also be coated with white patches; these white spots can be directly on the tonsils or simply at the back of the throat and sometimes have a yellowish colour instead of white.
In place of the white patches, you may notice long strips of white pus covering the tonsils; this is also a symptom of streptococcal pharyngitis.

Evaluating Other Common Symptoms

7) Be careful if you have been in the company of someone affected by the infection.
It is a contagious disease that spreads through direct contact with the bacterium that causes it. It is very unlikely that a streptococcal sore throat develops without having had direct contact with someone who is infected with it.
Keep in mind that it can be very difficult to know if someone else has an ongoing infection. Unless you have been completely isolated, it is likely that you may come into contact with someone who is ill.
It is also possible that some subjects are “healthy carriers” and can transmit streptococcus without presenting the symptoms.

8) Consider the speed at which the disease manifests itself.
A sore throat associated with streptococcus usually develops without warning and worsens very quickly. If the throat becomes increasingly painful over several days, most likely the cause is due to another factor.
However, even in this case, you should not completely rule out the possibility that it may be strep throat strep.

9) Measure the temperature.
Streptococcus infection is usually accompanied by a fever of at least 38.3 ° C or more. If the fever is lower it could still be caused by Streptococcus, but it is more likely to be a symptom of a viral infection.

10) Pay attention to a possible headache.
Even in this case, it is a common symptom of this infection and maybe a mild but also excruciating pain.

11) Monitor any digestive symptoms.
If you lose appetite or feel nauseous, you can consider it as another possible symptom of this disease. In some very serious cases, you may also suffer from vomiting and an upset stomach.

12) Observe your exhaustion.
As with any other infection, streptococcus pharyngitis can also lead to an increase in tiredness. You may find it harder than usual to wake up in the morning and have more difficulty doing your normal daily activities.

13) Check for a rash.
Severe streptococcal throat infection can cause a disease known as scarlet fever.

This red rash looks very similar to sandpaper.
Scarlet fever generally occurs 12-48 hours after the first symptoms of infection have emerged.
The rash usually begins in the area around the neck before it develops and spreads on the chest. Sometimes it also reaches the abdominal and inguinal areas. In rare cases, it can appear on the back, arms, legs or on the face.
If it is treated with antibiotics, generally, scarlet fever disappears rapidly. If you notice a rash of this nature, you should visit your doctor as soon as possible, regardless of the presence of other signs of streptococcal infection.

14) Pay attention to the symptoms that do not occur.
Although streptococcal cold and strep throat pain have many common symptoms, there are however several of the colds that are not found in people with streptococcal pharyngitis. The absence of these symptoms is another sign that may cause you to think you have an ongoing infection, rather than just a cold.
A streptococcal sore throat usually does not cause nasal symptoms. This means that you do not have a cough, rhinorrhea, stuffy nose or red and itchy eyes.
Also, while throat infection can cause stomach pain, it usually does not cause diarrhoea.

Evaluate Recent Clinical History and Risk Factors

15) Review your medical history.
Some people seem to be more prone to developing streptococcal infections than others. If you have a history of such infections, it is more likely that a new infection may also be caused by the same bacteria.

16) Evaluate if the age can help to contract the infection.
While 20-30% of sore throats in children is due to streptococcal pharyngitis, only 5-15% of adult medical examinations for pharyngeal pain actually detect the presence of streptococcal tonsillitis.
Elderly patients, as well as those with concomitant diseases (such as influenza), are more susceptible to opportunistic infections.

17) Understand if the environment you frequent increases the risk of streptococcal pharyngitis.
Often there is a greater chance of suffering from this infection when other family members have had it in the last two weeks. Sharing life or play spaces in enclosed spaces such as schools, kindergartens, dormitories and military barracks are all potentially at risk of colonization of bacteria.
Although the children most at risk of contracting the infection are those under 2 years of age who are less likely to be infected. However, they may not present the usual symptoms typical of older children and adults. They can have fever, rhinorrhea or a cough, as well as a loss of appetite. Inform your child’s doctor about the risk of your son taking a stingy throat sore throat, if you or another person with whom the child comes in contact have the infection and the baby has a fever or other symptoms.

18) Evaluate some risk factors that could make you more susceptible to infection.
Immunosuppressed individuals, who have a reduced ability to fight infections, may be at greater risk. Other infections or diseases can also increase the chances of being infected by streptococcus.
The immune system can be compromised simply because of fatigue. Some circumstances, such as a very intense exercise or physical effort (such as a marathon), can weigh heavily on the body. While the body focuses on recovery, its ability to fight infections is greatly reduced. In other words, an exhausted body puts all its energies to recover the physical forces and is not able to defend itself effectively.
Smoking can cause damage to the protective mucosa of the mouth and facilitate colonization of bacteria.
Oral sex can more directly expose the mouth and throat to bacteria.
Diabetes reduces the body’s ability to fight infections.

Get Visited by the Doctor

19) Know when it is advisable to visit a doctor.
Even if you do not have to talk to your doctor every time you have a sore throat, some potential symptoms of streptococcal pharyngitis should prompt you to fix an appointment promptly.  If a sore throat is accompanied by swollen lymph nodes, rash, difficulty swallowing or breathing, high fever or a fever lasting more than 48 hours, call the doctor to make an appointment.
You should contact your health care provider even if your sore throat lasts longer than 48 hours.

20) Tell your doctor about your concerns.
Bring him a complete list of symptoms and tell him you fear your illness may be due to Streptococcus. Generally, the health care provider verifies some of the most indicative signs of the disease.
The doctor could measure the temperature.
Expect also that you can observe in the throat with a light, as it will verify if the tonsils are swollen if there is a red and irregular rash on the tongue or white or yellow spots in the back of the throat.

21) Prepare for the doctor to implement a clinical diagnosis protocol.
This protocol basically consists of an organizational method of the doctor to evaluate the symptoms. For adults, the practitioner can use those that are known as the Centor criteria, or McIsaac score, to empirically evaluate how likely they are to have a group A streptococcus infection. It is simply a list of criteria that the doctor needs to check to determine if (and how) your infection should be treated.
The practitioner assigns scores, positive or negative, for the signs and symptoms present: +1 point if you have white or milky spots on the tonsils (tonsil exudates), +1 point for cervical and neck lymphadenopathy (enlarged lymph), +1 point if you have had a recent fever, +1 point if you are under 15, 0 points for an age between 15 and 45, -1 point if you are over 45 and -1 point in the presence of a cough.
If the result is 3-4 points, this means that there is a positive predictive value (VPP) of approximately 80% indicating that you are affected by a group A streptococcal infection; you are basically considered to be positive for streptococcus. In this case, the infection must be treated with antibiotics and the doctor will prescribe the correct treatment.

22) Ask your doctor for a rapid streptococcal test (RAD test).

Centor criteria are not effective in assessing infections that need to be treated with antibiotics in children. However, it is possible to perform a quick test of the streptococcal antigen directly in the doctor’s office and it takes very few minutes to complete.
The practitioner uses a cotton swab (similar to a cotton bud) to take samples of fluids in the back of the throat to check for bacteria. These fluids will then be analyzed in the same clinic and within 5 or 10 minutes the results should be known.

23) Ask the doctor to perform a pharyngeal swab.
If the results of the rapid test are negative, but you still find other symptoms of a streptococcal sore throat, the doctor may decide to undergo a longer test, known as a pharyngeal swab. A sample of bacteria from the throat is taken which we will try to grow in vitro at a laboratory. As the colony of collected bacteria grows, it will be easier to spot a large amount of group A streptococcus bacteria. The doctor will probably make use of all possible tests, from Cantor’s criteria to the rapid test, to the throat culture, for arriving at a clinical diagnosis.
Although the rapid test is usually sufficient to determine the presence of a streptococcus infection, it is also possible to obtain false negatives. The culture of the pharyngeal swab, in comparison, provides a much more precise outcome.
Keep in mind that it is not necessary to take a swab if the rapid test is positive because the RAD test is able to detect the antigens directly to the bacteria and is positive only if there is a certain amount of bacteria. In this case, immediate treatment with antibiotics is necessary.
The doctor uses a cotton swab to collect a fluid sample at the back of the throat and send the swab to a laboratory, where they will transfer the sample to a Petri dish. This disc incubates the sample for 18-48 hours, depending on the specific methodology used in the laboratory. If you have streptococcal pharyngitis, you will notice the Group A Streptococcus Beta bacteria that will grow on the plate.

24) Learn about other possible diagnostic tests.
Some doctors prefer a nucleic acid amplification test (NAAT) instead of a pharyngeal buffer when the rapid test gives a negative result. This is a careful examination that shows the result in a few hours, instead of requiring 1-2 days of incubation.

25) Take antibiotics if you are prescribed by your doctor.

Streptococcal pharyngitis is a bacterial infection and, as such, is effectively treated with antibiotics. If you have known allergies to antibiotics (such as penicillin), it is important to tell the medical staff, so that you find appropriate alternatives to your situation.
A typical cycle of antibiotics usually lasts up to 10 days (based on the specific medications your doctor has told you). Be sure to take all the antibiotics for as long as you are prescribed, even if you start feeling better before completing the entire cycle.
Penicillin, amoxicillin, cephalosporins and azithromycin are all equally available antibiotics that can be used to treat the infection. Penicillin is often prescribed and is effective in treating this infection. However, some individuals may have allergic reactions to this medication. You must inform your health care provider if you are aware of this possible side effect. Amoxicillin is another drug that is chosen for staph or throat sore and shows good results. Its effectiveness is similar to that of penicillin and resists better to gastric acids before being absorbed into the body. Furthermore, it has a wider spectrum of activity than penicillin.
Azithromycin, erythromycin, or cephalosporins are prescribed as alternative solutions to penicillin when a person is sure of being allergic to it. Keep in mind that erythromycin has major gastrointestinal side effects.

26) Try to stay comfortable, comfortable and rest during treatment with antibiotics.
Usually, healing occurs when the cycle of drugs ends (about 10 days). During the convalescence, you give your body the chance to recover.
Sleeping more, drinking herbal teas and lots of fluids can help relieve throat pain during the healing process.
In addition, sometimes it is also useful to consume cold drinks, ice cream and popsicles to relieve throat pain.

27) Go to the doctor for further checks, if necessary.
Within 2 or 3 days you should start to feel better, but if you do not, or if you still have a fever, you should contact your doctor. Call it immediately even if you show signs of an allergic reaction to antibiotics. Among these, the main ones are a rash, urticaria or swelling after taking the antibiotic.

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