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Streptococcal pharyngitis

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427: 453: 2833: 409: 498:. It is spread by direct, close contact with an infected person; thus crowding, as may be found in the military and schools, increases the rate of transmission. Dried bacteria in dust are not infectious, although moist bacteria on toothbrushes or similar items can persist for up to fifteen days. Contaminated food can result in outbreaks, but this is rare. Of children with no signs or symptoms, 12% carry GAS in their pharynx, and, after treatment, approximately 15% of those remain positive, and are true "carriers". 50: 783:. The arguments in favor of antibiotic treatment should be balanced by the consideration of possible side effects, and it is reasonable to suggest that no antimicrobial treatment be given to healthy adults who have adverse reactions to medication or those at low risk of complications. Antibiotics are prescribed for strep throat at a higher rate than would be expected from how common it is. 2182: 818:
The symptoms of strep throat usually improve within three to five days, irrespective of treatment. Treatment with antibiotics reduces the risk of complications and transmission; children may return to school 24 hours after antibiotics are administered. The risk of complications in adults is low. In
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may be a reasonable preventive measure in those with frequent throat infections (more than three a year). However, the benefits are small and episodes typically lessen in time regardless of measures taken. Recurrent episodes of pharyngitis which test positive for GAS may also represent a person who
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A positive throat culture or RADT in association with symptoms establishes a positive diagnosis in those in which the diagnosis is in doubt. In adults, a negative RADT is sufficient to rule out the diagnosis. However, in children a throat culture is recommended to confirm the result. Asymptomatic
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may be used in those with less severe allergies and some low-certainty evidence suggest cephalosporins are superior to penicillin. These late-generation antibiotics show a similar effect when prescribed for 3–7 days in comparison to the standard ten days of penicillin when used in areas of low
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from an infected person, spread by talking, coughing or sneezing, or by touching something that has droplets on it and then touching the mouth, nose, or eyes. As with all respiratory pathogens once presumed to transmit via respiratory droplets, it is highly likely to be carried by the aerosols
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is a chronic carrier of GAS who is getting recurrent viral infections. Treating people who have been exposed but who are without symptoms is not recommended. Treating people who are carriers of GAS is not recommended as the risk of spread and complications is low.
885:, the broader category into which Streptococcal pharyngitis falls, is diagnosed in 11 million people annually in the United States. It is the cause of 15–40% of sore throats among children and 5–15% in adults. Cases usually occur in late winter and early spring. 719:
Untreated streptococcal pharyngitis usually resolves within a few days. Treatment with antibiotics shortens the duration of the acute illness by about 16 hours. The primary reason for treatment with antibiotics is to reduce the risk of complications such as
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generated during routine breathing, talking, and even singing. It may be spread directly through touching infected sores. It may also be spread by contact with skin infected with group A strep. The diagnosis is made based on the results of a
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Strep throat is a common bacterial infection in children. It is the cause of 15–40% of sore throats among children and 5–15% among adults. Cases are more common in late winter and early spring. Potential complications include
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individuals should not be routinely tested with a throat culture or RADT because a certain percentage of the population persistently "carries" the streptococcal bacteria in their throat without any harmful results.
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Altamimi S, Khalil A, Khalaiwi KA, Milner RA, Pusic MV, Al Othman MA (15 August 2012). "Short-term late-generation antibiotics versus longer term penicillin for acute streptococcal pharyngitis in children".
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is only recommended in those with a confirmed diagnosis. Those infected should stay away from other people until fever is gone and for at least 12 hours after starting treatment. Pain can be treated with
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recommends against routine antibiotic treatment and considers antibiotics only appropriate when given after a positive test. Testing is not needed in children under three as both group A strep and
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A score of one may indicate no treatment or culture is needed or it may indicate the need to perform further testing if other high risk factors exist, such as a family member having the disease.
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children, acute rheumatic fever is rare in most of the developed world. It is, however, the leading cause of acquired heart disease in India, sub-Saharan Africa, and some parts of Australia.
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Appropriate antibiotics decrease the average 3–5 day duration of symptoms by about one day, and also reduce contagiousness. They are primarily prescribed to reduce rare complications such as
2474: 1783:"Selective testing strategies for diagnosing group A streptococcal infection in children with pharyngitis: a systematic review and prospective multicentre external validation study" 2617:
Stevens DL, Tanner MH, Winship J, et al. (July 1989). "Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A".
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Pichichero M, Casey, J (June 2006). "Comparison of European and U.S. results for cephalosporin versus penicillin treatment of group A streptococcal tonsillopharyngitis".
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Hildreth AF, Takhar S, Clark MA, Hatten B (September 2015). "Evidence-Based Evaluation And Management Of Patients With Pharyngitis In The Emergency Department".
2077: 1288:"Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America" 1684: 655:
As the symptoms of streptococcal pharyngitis overlap with other conditions, it can be difficult to make the diagnosis clinically. Coughing, nasal discharge,
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Shaikh N, Leonard E, Martin JM (September 2010). "Prevalence of streptococcal pharyngitis and streptococcal carriage in children: a meta-analysis".
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may help with the pain, they are not routinely recommended. Aspirin may be used in adults but is not recommended in children due to the risk of
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than of strep throat. The presence of marked lymph node enlargement along with sore throat, fever, and tonsillar enlargement may also occur in
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Snow V, Mottur-Pilson C, Cooper RJ, Hoffman JR (March 2001). "Principles of appropriate antibiotic use for acute pharyngitis in adults".
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A number of scoring systems exist to help with diagnosis; however, their use is controversial due to insufficient accuracy. The modified
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Lean WL, Arnup S, Danchin M, Steer AC (October 2014). "Rapid diagnostic tests for group A streptococcal pharyngitis: a meta-analysis".
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in the front of the neck. A headache and nausea or vomiting may also occur. Some develop a sandpaper-like rash which is known as
71: 625:(also called rapid antigen detection testing or RADT) may also be used. While the rapid strep test is quicker, it has a lower 3353: 1839: 1761: 1003: 965: 598: 1984:
Johnson BC, Alvi A (March 2003). "Cost-effective workup for tonsillitis. Testing, treatment, and potential complications".
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Hedin K, Thorning S, van Driel ML (2023-11-15). "Different antibiotic treatments for group A streptococcal pharyngitis".
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Brook I, Dohar JE (December 2006). "Management of group A beta-hemolytic streptococcal pharyngotonsillitis in children".
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A throat infection which on culture tested positive for group A streptococcus. Note the large tonsils with white
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Bonsignori F, Chiappini E, De Martino M (2010). "The infections of the upper respiratory tract in children".
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This is a culture-positive case of streptococcal pharyngitis with typical tonsillar exudate in an 8-year-old.
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Shulman ST, Bisno, AL, Clegg, HW, Gerber, MA, Kaplan, EL, Lee, G, Martin, JM, Van Beneden, C (Sep 9, 2012).
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The economic cost of the disease in the United States in children is approximately $ 350 million annually.
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Baltimore RS (February 2010). "Re-evaluation of antibiotic treatment of streptococcal pharyngitis".
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are a set of five criteria; the total score indicates the probability of a streptococcal infection.
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Wilbur C, Bitnun A, Kronenberg S, Laxer RM, Levy DM, Logan WJ, Shouldice M, Yeh EA (May 2019).
993: 862: 684: 246: 241: 142: 2937: 1751: 955: 481:). Humans are the primary natural reservoir for group A streptococcus. Other bacteria such as 4070: 3129: 3101: 1100:
Wang CC, Prather KA, Sznitman J, Jimenez JL, Lakdawala SS, Tufekci Z, Marr LC (27 Aug 2021).
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is preferred in Europe. In India, where the risk of rheumatic fever is higher, intramuscular
728:. Antibiotics prevent acute rheumatic fever if given within 9 days of the onset of symptoms. 692: 326: 293: 177: 159: 108: 2374: 3746: 3698: 3686: 3500: 3458: 3057: 2237: 2137:"Tonsillectomy Versus Watchful Waiting for Recurrent Throat Infection: A Systematic Review" 1056:"Clinical Mimics: An Emergency Medicine-Focused Review of Streptococcal Pharyngitis Mimics" 842: 618: 354: 266: 3358: 2027:
van Staaij BK, van den Akker EH, van der Heijden GJ, Schilder AG, Hoes AW (January 2005).
1834:. In a Page Series. Hagerstown, Maryland: Lippincott Williams & Wilkins. p. 312. 1711:"Predictors for spread of clinical group A streptococcal tonsillitis within the household" 8: 4014: 3981: 3727: 3676: 3304: 3124: 2991: 2897: 630: 626: 559: 381: 277: 273:. Symptoms typically begin one to three days after exposure and last seven to ten days. 3872: 3737: 3693: 3525: 3446: 3373: 3243: 2805: 2778: 2759: 2705: 2680: 2499: 2386: 2340: 2297: 2214: 2197: 2169: 2105: 2053: 2028: 2009: 1880: 1807: 1782: 1781:
Cohen JF, Cohen R, Levy C, Thollot F, Benani M, Bidet P, Chalumeau M (6 January 2015).
1656: 1314: 1287: 1233: 1178: 1153: 1126: 1101: 847: 810:; however, the incidence of this side effect is not reduced by the use of antibiotics. 798: 688: 300:, and not sharing eating utensils. There is no vaccine for the disease. Treatment with 155: 78: 2902: 740:(acetaminophen) helps in the management of pain associated with strep throat. Viscous 395:
Symptoms typically begin one to three days after exposure and last seven to ten days.
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Hahn RG, Knox LM, Forman TA (May 2005). "Evaluation of poststreptococcal illness".
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for the diagnosis of streptococcal pharyngitis, with a sensitivity of 90–95%. A
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is uncommon, a negative rapid strep test is sufficient to rule out the disease.
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Morad A, Sathe NA, Francis DO, McPheeters ML, Chinnadurai S (17 January 2017).
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The antibiotic of choice in the United States for streptococcal pharyngitis is
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Wing A, Villa-Roel, C, Yeh, B, Eskin, B, Buckingham, J, Rowe, BH (May 2010).
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Primary care medicine: office evaluation and management of the adult patient
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A culture positive case of streptococcal pharyngitis with typical tonsillar
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A set of large tonsils in the back of the throat, covered in white exudate.
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Bisno AL, Gerber MA, Gwaltney JM, Kaplan EL, Schwartz RH (July 2002).
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Lindbaek M, Høiby EA, Lermark G, Steinsholt IM, Hjortdahl P (2004).
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Complications arising from streptococcal throat infections include:
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Moretti G, Pasquini M, Mandarelli G, Tarsitani L, Biondi M (2008).
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European Journal of Clinical Microbiology & Infectious Diseases
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rheumatic heart disease. Streptococcal infections may also lead to
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Burton MJ, Glasziou PP, Chong LY, Venekamp RP (19 November 2014).
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The typical signs and symptoms of streptococcal pharyngitis are a
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Knowledge's health care articles can be viewed offline with the
1587:"Management of Group A beta-hemolytic streptococcal pharyngitis" 3369: 3182: 3111: 2882: 2867: 2265: 852: 365: 236: 192: 2360: 1708: 1363:"Pharyngitis (Strep Throat): Information For Clinicians | CDC" 663:
in addition to fever and sore throat are more indicative of a
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of greater than 38 °C (100 °F), tonsillar exudates (
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Linder JA, Bates DW, Lee GM, Finkelstein JA (November 2005).
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David A.Warrell, Timothy M. Cox, John D. Firth, eds. (2012).
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Smith, Ellen Reid, Kahan, Scott, Miller, Redonda G. (2008).
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are rare, unless a child has a sibling with the disease.
346: 1095: 1093: 1091: 2351: 633:(98%) as a throat culture. In areas of the world where 289:. Some people may carry the bacteria without symptoms. 2990: 2727: 2681:"PANDAS/PANS in childhood: Controversies and evidence" 2516: 1511:"Diagnosis and treatment of streptococcal pharyngitis" 671:. Other conditions that may present similarly include 590:
Age less than 15 (a point is subtracted if age >44)
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Strep throat is unlikely when any of the symptoms of
2845: 2616: 1900: 1898: 1896: 1894: 2730:"Treatment of PANDAS and PANS: a systematic review" 2433:"Antibiotic treatment of children with sore throat" 1207: 1053: 2471: 1891: 1421:Harris AM, Hicks LA, Qaseem A (19 January 2016). 1420: 4057: 2196:Thomas M, Del Mar C, Glasziou P (October 2000). 1680:U. S. Centers for Disease Control and Prevention 2728:Sigra S, Hesselmark E, Bejerot S (March 2018). 1685:U. S. Department of Health & Human Services 1584: 1338:"ICD-11 for Mortality and Morbidity Statistics" 2651: 1750:Robert E. Rakel, David P. Rakel, eds. (2011). 1102:"Airborne transmission of respiratory viruses" 2976: 1951:"Epstein-Barr virus infectious mononucleosis" 1580: 1578: 1576: 1574: 1572: 1570: 574:One point is given for each of the criteria: 1942: 1702: 1630: 1504: 1502: 1500: 1498: 1496: 1494: 1492: 1490: 1488: 1486: 1484: 1482: 1480: 1478: 991: 987: 985: 983: 981: 584:Temperature >38.0 °C (100.4 °F) 2770: 2594: 2592: 2519:The Cochrane Database of Systematic Reviews 2085:The Cochrane Database of Systematic Reviews 1983: 1626: 1624: 1622: 1620: 1618: 1616: 1542: 1540: 1476: 1474: 1472: 1470: 1468: 1466: 1464: 1462: 1460: 1458: 1390: 1388: 1386: 1384: 1281: 1279: 1277: 1275: 1273: 1271: 1269: 1267: 2983: 2969: 2672: 1567: 1546: 1400:Centers for Disease Control and Prevention 1265: 1263: 1261: 1259: 1257: 1255: 1253: 1251: 1249: 1247: 1203: 1201: 1199: 1197: 1054:Gottlieb M, Long B, Koyfman A (May 2018). 912: 910: 908: 906: 904: 902: 900: 898: 764:, due to safety, cost, and effectiveness. 388:, the latter being an uncommon but highly 48: 3583:Combined pulmonary fibrosis and emphysema 2804: 2794: 2745: 2721: 2704: 2448: 2283: 2213: 2168: 2104: 2052: 1925: 1806: 1726: 1438: 1313: 1303: 1177: 1147: 1145: 1125: 1071: 1049: 1047: 978: 949: 947: 945: 943: 941: 939: 644: 2645: 2589: 2189: 1948: 1613: 1537: 1508: 1455: 1381: 83:Fever, sore throat, enlarged lymph nodes 3607:Allergic bronchopulmonary aspergillosis 2567:Cochrane Database of Systematic Reviews 2375:10.7326/0003-4819-134-6-200103200-00018 1414: 1355: 1244: 1194: 895: 797:are recommended for people with severe 581:Swollen and tender cervical lymph nodes 43:Streptococcal sore throat, strep throat 14: 4058: 2397: 1142: 1044: 1021: 1019: 936: 2964: 1585:Hayes CS, Williamson H (April 2001). 1330: 1151: 957:Oxford textbook of medicine infection 772:G is the first choice for treatment. 608: 599:Infectious Disease Society of America 446:finding in streptococcal pharyngitis. 332: 2185:from the original on 13 August 2017. 1787:Canadian Medical Association Journal 1027:"Strep throat - Symptoms and causes" 924:from the original on 2 February 2016 540:Antibiotic based on culture or RADT 311:nonsteroidal anti-inflammatory drugs 4040:Idiopathic pulmonary haemosiderosis 1016: 736:Pain medication such as NSAIDs and 24: 4066:Acute upper respiratory infections 3629:Vaping-associated pulmonary injury 2992:Diseases of the respiratory system 843:Streptococcal toxic shock syndrome 731: 432:Mouth wide open showing the throat 414:Mouth wide open showing the throat 25: 4087: 2825: 1060:The Journal of Emergency Medicine 442:. This is an uncommon but highly 121:Sharing drinks or eating utensils 2831: 2783:Clin Pract Epidemiol Ment Health 2606:from the original on 2008-12-08. 2285:10.1111/j.1553-2712.2010.00723.x 2124:from the original on 2022-10-10. 2033:Archives of Disease in Childhood 1973:from the original on 2008-07-24. 1770:from the original on 2017-09-08. 1609:from the original on 2008-05-16. 1533:from the original on 2015-02-08. 1012:from the original on 2016-09-15. 992:Goroll AH, Mulley AG Jr (2009). 974:from the original on 2016-10-10. 822: 529:No antibiotic or culture needed 451: 425: 407: 2747:10.1016/j.neubiorev.2018.01.001 2610: 2557: 2510: 2465: 2424: 2308: 2259: 2248:from the original on 2010-04-08 2230: 2128: 2069: 2020: 1977: 1848: 1823: 1774: 1743: 1691:from the original on 2020-10-27 1667: 877: 4045:Pulmonary alveolar proteinosis 2575:10.1002/14651858.CD004872.pub3 2531:10.1002/14651858.CD004406.pub6 2097:10.1002/14651858.CD001802.pub3 1832:In A Page Signs & Symptoms 1073:10.1016/j.jemermed.2018.01.031 755: 629:(70%) and statistically equal 180:, Handwashing, covering coughs 13: 1: 3619:Idiopathic pulmonary fibrosis 888: 702: 587:Tonsillar exudate or swelling 438:, or small red spots, on the 3602:Respiratory hypersensitivity 3540:Hypersensitivity pneumonitis 2317:Int J Immunopathol Pharmacol 1645:10.1097/MOP.0b013e32833502e7 1396:"Is your sore throat strep?" 1292:Clinical Infectious Diseases 813: 714: 501: 283:rapid antigen detection test 7: 3511:Coalworker's pneumoconiosis 2631:10.1056/NEJM198907063210101 2406:Emergency Medicine Practice 2272:Academic Emergency Medicine 1753:Textbook of family medicine 1427:Annals of Internal Medicine 10: 4092: 3364:Acute exacerbation of COPD 2329:10.1177/03946320100230S105 744:may also be useful. While 648: 470:Strep throat is caused by 276:Strep throat is spread by 253:. Common symptoms include 217:streptococcal sore throat 4007: 3980: 3910: 3896: 3850: 3808: 3787: 3761: 3664: 3650: 3641: 3570: 3455: 3435: 3318: 3298: 3138: 3018: 2998: 2923: 2849: 2488:10.1007/s10096-006-0154-7 1728:10.1080/02813430410006729 1170:10.1016/j.pop.2013.10.010 920:. CDC. October 19, 2015. 726:retropharyngeal abscesses 681:acute retroviral syndrome 539: 213:Streptococcal pharyngitis 202: 184: 173: 141: 125: 115: 103: 95: 87: 77: 65: 56: 47: 39: 35:Streptococcal pharyngitis 34: 4076:Streptococcal infections 3427:Diffuse panbronchiolitis 3420:Bronchiolitis obliterans 3286:Laryngotracheal stenosis 3233:Laryngopharyngeal reflux 3211:Laryngopharyngeal reflux 3169:Laryngopharyngeal reflux 3097:Nasal septum perforation 2450:10.1001/jama.294.18.2315 1998:10.3810/pgm.2003.03.1391 1715:Scand J Prim Health Care 808:acute glomerulonephritis 669:infectious mononucleosis 483:non–group A β-hemolytic 465: 360:Other symptoms include: 206:5 to 40% of sore throats 152:infectious mononucleosis 3175:Retropharyngeal abscess 2045:10.1136/adc.2003.047530 1555:(12): S1–11, quiz S12. 1509:Choby BA (March 2009). 1118:10.1126/science.abd9149 697:retropharyngeal abscess 164:retropharyngeal abscess 91:1–3 days after exposure 3868:Pulmonary hypertension 3597:Eosinophilic pneumonia 3249:Vocal cord dysfunction 3092:Nasal septum deviation 2796:10.1186/1745-0179-4-13 2412:(9): 1–16, quiz 16–7. 2153:10.1542/peds.2016-3490 1869:10.1542/peds.2014-1094 1222:10.1542/peds.2009-2648 1152:Weber R (March 2014). 863:Cervical lymphadenitis 645:Differential diagnosis 507:Modified Centor score 242:Streptococcus pyogenes 143:Differential diagnosis 3995:Mediastinal emphysema 3774:Healthcare-associated 3704:Legionnaires' disease 3130:Peritonsillar abscess 3102:Nasal septal hematoma 2840:Medical Knowledge app 2734:Neurosci Biobehav Rev 2685:Paediatr Child Health 918:"Is It Strep Throat?" 858:Peritonsillar abscess 833:Acute rheumatic fever 781:peritonsillar abscess 770:benzathine penicillin 693:peritonsillar abscess 327:peritonsillar abscess 251:group A streptococcus 160:peritonsillar abscess 109:Group A streptococcus 3742:Mendelson's syndrome 3614:Hamman–Rich syndrome 799:penicillin allergies 515:Probability of Strep 472:group A β-hemolytic 355:cervical lymph nodes 309:(acetaminophen) and 294:airborne precautions 278:respiratory droplets 178:Airborne precautions 4015:Respiratory failure 3982:Mediastinal disease 3550:Bird fancier's lung 3125:Adenoid hypertrophy 1799:10.1503/cmaj.140772 1633:Curr. Opin. Pediatr 801:. First-generation 685:Lemierre's syndrome 661:red, irritated eyes 560:Empiric antibiotics 508: 382:scarlatiniform rash 292:Prevention is with 3920:Pleuritis/pleurisy 3873:Pulmonary embolism 3769:Community-acquired 3694:Atypical bacterial 3593:Löffler's syndrome 3374:Status asthmaticus 3359:Chronic bronchitis 3244:Vocal fold paresis 3058:Vasomotor rhinitis 2924:External resources 2697:10.1093/pch/pxy145 1369:. 19 December 2022 1305:10.1093/cid/cis629 848:Glomerulonephritis 609:Laboratory testing 578:Absence of a cough 506: 333:Signs and symptoms 235:, the back of the 72:Infectious disease 4053: 4052: 4003: 4002: 3960:Empyema/pyothorax 3892: 3891: 3888: 3887: 3846: 3845: 3779:Hospital-acquired 3637: 3636: 3501:Caplan's syndrome 3294: 3293: 3239:Vocal fold nodule 3063:Atrophic rhinitis 2958: 2957: 2323:(1 Suppl): 16–9. 1992:(3): 115–8, 121. 1949:Ebell MH (2004). 1914:Clin. Infect. Dis 1841:978-0-7817-7043-9 1763:978-1-4377-1160-8 1402:. 2 November 2022 1005:978-0-7817-7513-7 967:978-0-19-163173-3 665:viral sore throat 651:Acute pharyngitis 565: 564: 386:palatal petechiae 313:(NSAIDs) such as 210: 209: 191:(acetaminophen), 168:viral pharyngitis 127:Diagnostic method 61:in a 16-year-old. 29:Medical condition 16:(Redirected from 4083: 3938:Pleural effusion 3931:Hemopneumothorax 3908: 3907: 3662: 3661: 3648: 3647: 3491:Bauxite fibrosis 3456:External agents/ 3453: 3452: 3384:Exercise-induced 3340:Acute bronchitis 3316: 3315: 3016: 3015: 2985: 2978: 2971: 2962: 2961: 2847: 2846: 2835: 2819: 2818: 2808: 2798: 2774: 2768: 2767: 2749: 2725: 2719: 2718: 2708: 2676: 2670: 2669: 2654:Am Fam Physician 2649: 2643: 2642: 2614: 2608: 2607: 2596: 2587: 2586: 2561: 2555: 2554: 2545: 10646936. 2525:(11): CD004406. 2514: 2508: 2507: 2469: 2463: 2462: 2452: 2428: 2422: 2421: 2401: 2395: 2394: 2358: 2349: 2348: 2312: 2306: 2305: 2287: 2263: 2257: 2256: 2254: 2253: 2234: 2228: 2227: 2217: 2193: 2187: 2186: 2172: 2147:(2): e20163490. 2132: 2126: 2125: 2123: 2108: 2091:(11): CD001802. 2082: 2073: 2067: 2066: 2056: 2024: 2018: 2017: 1981: 1975: 1974: 1955:Am Fam Physician 1946: 1940: 1939: 1929: 1911: 1902: 1889: 1888: 1852: 1846: 1845: 1827: 1821: 1820: 1810: 1778: 1772: 1771: 1747: 1741: 1740: 1730: 1706: 1700: 1699: 1697: 1696: 1671: 1665: 1664: 1628: 1611: 1610: 1591:Am Fam Physician 1582: 1565: 1564: 1544: 1535: 1534: 1515:Am Fam Physician 1506: 1453: 1452: 1442: 1440:10.7326/M15-1840 1418: 1412: 1411: 1409: 1407: 1392: 1379: 1378: 1376: 1374: 1359: 1353: 1352: 1350: 1348: 1334: 1328: 1327: 1317: 1307: 1283: 1242: 1241: 1205: 1192: 1191: 1181: 1149: 1140: 1139: 1129: 1097: 1086: 1085: 1075: 1051: 1042: 1041: 1039: 1037: 1023: 1014: 1013: 989: 976: 975: 951: 934: 933: 931: 929: 914: 677:Kawasaki disease 623:rapid strep test 509: 505: 455: 429: 411: 215:, also known as 52: 32: 31: 21: 4091: 4090: 4086: 4085: 4084: 4082: 4081: 4080: 4056: 4055: 4054: 4049: 3999: 3976: 3912:Pleural disease 3901: 3884: 3842: 3804: 3788:By distribution 3783: 3762:By vector/route 3757: 3655: 3643: 3633: 3588:Pulmonary edema 3566: 3461: 3457: 3444: 3440: 3431: 3396:Cystic fibrosis 3323: 3307: 3303: 3290: 3134: 3008: 3002: 2994: 2989: 2959: 2954: 2953: 2919: 2918: 2858: 2844: 2836: 2828: 2823: 2822: 2775: 2771: 2726: 2722: 2677: 2673: 2660:(10): 1949–54. 2650: 2646: 2619:N. Engl. J. Med 2615: 2611: 2598: 2597: 2590: 2569:(8): CD004872. 2562: 2558: 2515: 2511: 2470: 2466: 2443:(18): 2315–22. 2429: 2425: 2402: 2398: 2359: 2352: 2313: 2309: 2264: 2260: 2251: 2249: 2242:MedicineNet.com 2236: 2235: 2231: 2208:(459): 817–20. 2194: 2190: 2133: 2129: 2121: 2080: 2074: 2070: 2025: 2021: 1982: 1978: 1947: 1943: 1909: 1903: 1892: 1853: 1849: 1842: 1828: 1824: 1779: 1775: 1764: 1748: 1744: 1707: 1703: 1694: 1692: 1675:"Group A Strep" 1673: 1672: 1668: 1629: 1614: 1583: 1568: 1545: 1538: 1507: 1456: 1419: 1415: 1405: 1403: 1394: 1393: 1382: 1372: 1370: 1361: 1360: 1356: 1346: 1344: 1336: 1335: 1331: 1298:(10): e86–102. 1284: 1245: 1206: 1195: 1150: 1143: 1098: 1089: 1052: 1045: 1035: 1033: 1025: 1024: 1017: 1006: 990: 979: 968: 952: 937: 927: 925: 916: 915: 896: 891: 880: 872: 853:PANDAS syndrome 825: 816: 777:rheumatic fever 758: 734: 732:Pain medication 722:rheumatic fever 717: 705: 689:Ludwig's angina 653: 647: 635:rheumatic fever 611: 603:rheumatic fever 569:Centor criteria 504: 494:may also cause 468: 461: 459: 456: 447: 433: 430: 421: 415: 412: 335: 323:rheumatic fever 265:, and enlarged 156:Ludwig's angina 30: 23: 22: 15: 12: 11: 5: 4089: 4079: 4078: 4073: 4068: 4051: 4050: 4048: 4047: 4042: 4037: 4032: 4027: 4022: 4017: 4011: 4009: 4005: 4004: 4001: 4000: 3998: 3997: 3992: 3986: 3984: 3978: 3977: 3975: 3974: 3968: 3967: 3962: 3957: 3952: 3947: 3942: 3940: 3934: 3933: 3923: 3922: 3916: 3914: 3905: 3898:Pleural cavity 3894: 3893: 3890: 3889: 3886: 3885: 3883: 3882: 3877: 3876: 3875: 3870: 3860: 3854: 3852: 3848: 3847: 3844: 3843: 3841: 3840: 3835: 3830: 3825: 3820: 3814: 3812: 3806: 3805: 3803: 3802: 3797: 3791: 3789: 3785: 3784: 3782: 3781: 3776: 3771: 3765: 3763: 3759: 3758: 3756: 3755: 3754: 3753: 3744: 3730: 3725: 3724: 3723: 3713: 3712: 3711: 3706: 3701: 3691: 3690: 3689: 3684: 3674: 3668: 3666: 3659: 3645: 3639: 3638: 3635: 3634: 3632: 3631: 3626: 3621: 3616: 3611: 3610: 3609: 3599: 3590: 3585: 3580: 3574: 3572: 3568: 3567: 3565: 3564: 3563: 3562: 3560:Lycoperdonosis 3557: 3552: 3547: 3536: 3535: 3534: 3533: 3528: 3523: 3518: 3513: 3508: 3503: 3498: 3493: 3488: 3483: 3478: 3471:Pneumoconiosis 3467: 3465: 3450: 3433: 3432: 3430: 3429: 3424: 3423: 3422: 3412: 3407: 3405: 3399: 3398: 3393: 3391:Bronchiectasis 3388: 3387: 3386: 3381: 3376: 3367: 3361: 3351: 3349: 3343: 3342: 3337: 3335: 3329: 3327: 3313: 3296: 3295: 3292: 3291: 3289: 3288: 3283: 3278: 3276: 3268: 3267: 3262: 3260: 3252: 3251: 3246: 3241: 3236: 3230: 3228: 3220: 3219: 3214: 3208: 3203: 3201:Laryngeal cyst 3198: 3196:Laryngomalacia 3193: 3188: 3186: 3178: 3177: 3172: 3166: 3165: 3164: 3154: 3152: 3144: 3142: 3136: 3135: 3133: 3132: 3127: 3122: 3117: 3115: 3107: 3106: 3105: 3104: 3099: 3094: 3082: 3077: 3072: 3071: 3070: 3065: 3060: 3050: 3048: 3040: 3039: 3034: 3032: 3024: 3022: 3013: 2996: 2995: 2988: 2987: 2980: 2973: 2965: 2956: 2955: 2952: 2951: 2940: 2928: 2927: 2925: 2921: 2920: 2917: 2916: 2905: 2890: 2875: 2859: 2854: 2853: 2851: 2850:Classification 2830: 2829: 2827: 2826:External links 2824: 2821: 2820: 2769: 2720: 2671: 2644: 2609: 2600:"UpToDate Inc" 2588: 2556: 2509: 2464: 2437:J Am Med Assoc 2423: 2396: 2363:Ann Intern Med 2350: 2307: 2258: 2229: 2202:Br J Gen Pract 2188: 2127: 2068: 2019: 1976: 1961:(7): 1279–87. 1941: 1927:10.1086/340949 1890: 1847: 1840: 1822: 1773: 1762: 1742: 1701: 1687:. 2019-04-19. 1666: 1612: 1597:(8): 1557–64. 1566: 1536: 1454: 1413: 1380: 1354: 1329: 1243: 1216:(3): e557–64. 1193: 1141: 1087: 1066:(5): 619–629. 1043: 1015: 1004: 977: 966: 935: 893: 892: 890: 887: 879: 876: 871: 870: 865: 860: 855: 850: 845: 840: 835: 829: 824: 821: 815: 812: 803:cephalosporins 757: 754: 733: 730: 716: 713: 704: 701: 646: 643: 615:throat culture 610: 607: 592: 591: 588: 585: 582: 579: 563: 562: 557: 554: 550: 549: 546: 542: 541: 538: 535: 531: 530: 527: 524: 520: 519: 516: 513: 503: 500: 467: 464: 463: 462: 457: 450: 448: 431: 424: 422: 413: 406: 374:abdominal pain 334: 331: 287:throat culture 208: 207: 204: 200: 199: 186: 182: 181: 175: 171: 170: 145: 139: 138: 132:Throat culture 129: 123: 122: 119: 113: 112: 105: 101: 100: 97: 93: 92: 89: 85: 84: 81: 75: 74: 69: 63: 62: 54: 53: 45: 44: 41: 37: 36: 28: 9: 6: 4: 3: 2: 4088: 4077: 4074: 4072: 4069: 4067: 4064: 4063: 4061: 4046: 4043: 4041: 4038: 4036: 4033: 4031: 4028: 4026: 4023: 4021: 4018: 4016: 4013: 4012: 4010: 4008:Other/general 4006: 3996: 3993: 3991: 3990:Mediastinitis 3988: 3987: 3985: 3983: 3979: 3973: 3970: 3969: 3966: 3963: 3961: 3958: 3956: 3953: 3951: 3948: 3946: 3943: 3941: 3939: 3936: 3935: 3932: 3928: 3925: 3924: 3921: 3918: 3917: 3915: 3913: 3909: 3906: 3904: 3899: 3895: 3881: 3878: 3874: 3871: 3869: 3866: 3865: 3864: 3861: 3859: 3856: 3855: 3853: 3849: 3839: 3836: 3834: 3831: 3829: 3826: 3824: 3821: 3819: 3816: 3815: 3813: 3811: 3807: 3801: 3798: 3796: 3793: 3792: 3790: 3786: 3780: 3777: 3775: 3772: 3770: 3767: 3766: 3764: 3760: 3752: 3748: 3745: 3743: 3739: 3736: 3735: 3734: 3733:noninfectious 3731: 3729: 3726: 3722: 3719: 3718: 3717: 3714: 3710: 3707: 3705: 3702: 3700: 3697: 3696: 3695: 3692: 3688: 3685: 3683: 3680: 3679: 3678: 3675: 3673: 3670: 3669: 3667: 3663: 3660: 3658: 3653: 3649: 3646: 3642:Obstructive / 3640: 3630: 3627: 3625: 3622: 3620: 3617: 3615: 3612: 3608: 3605: 3604: 3603: 3600: 3598: 3594: 3591: 3589: 3586: 3584: 3581: 3579: 3576: 3575: 3573: 3569: 3561: 3558: 3556: 3555:Farmer's lung 3553: 3551: 3548: 3546: 3543: 3542: 3541: 3538: 3537: 3532: 3529: 3527: 3524: 3522: 3519: 3517: 3514: 3512: 3509: 3507: 3504: 3502: 3499: 3497: 3494: 3492: 3489: 3487: 3484: 3482: 3479: 3477: 3474: 3473: 3472: 3469: 3468: 3466: 3464: 3460: 3454: 3451: 3448: 3443: 3438: 3434: 3428: 3425: 3421: 3418: 3417: 3416: 3415:Bronchiolitis 3413: 3411: 3408: 3406: 3404: 3401: 3400: 3397: 3394: 3392: 3389: 3385: 3382: 3380: 3377: 3375: 3371: 3368: 3365: 3362: 3360: 3357: 3356: 3355: 3352: 3350: 3348: 3345: 3344: 3341: 3338: 3336: 3334: 3331: 3330: 3328: 3326: 3321: 3317: 3314: 3311: 3306: 3301: 3297: 3287: 3284: 3282: 3279: 3277: 3275: 3274: 3270: 3269: 3266: 3263: 3261: 3259: 3258: 3254: 3253: 3250: 3247: 3245: 3242: 3240: 3237: 3234: 3231: 3229: 3227: 3226: 3222: 3221: 3218: 3215: 3212: 3209: 3207: 3204: 3202: 3199: 3197: 3194: 3192: 3189: 3187: 3185: 3184: 3180: 3179: 3176: 3173: 3170: 3167: 3163: 3160: 3159: 3158: 3155: 3153: 3151: 3150: 3146: 3145: 3143: 3141: 3137: 3131: 3128: 3126: 3123: 3121: 3118: 3116: 3114: 3113: 3109: 3108: 3103: 3100: 3098: 3095: 3093: 3090: 3089: 3088: 3087: 3083: 3081: 3078: 3076: 3073: 3069: 3066: 3064: 3061: 3059: 3056: 3055: 3054: 3051: 3049: 3047: 3046: 3042: 3041: 3038: 3035: 3033: 3031: 3030: 3026: 3025: 3023: 3021: 3017: 3014: 3011: 3006: 3001: 2997: 2993: 2986: 2981: 2979: 2974: 2972: 2967: 2966: 2963: 2950: 2946: 2945: 2941: 2939: 2935: 2934: 2930: 2929: 2926: 2922: 2915: 2911: 2910: 2906: 2904: 2900: 2899: 2895: 2891: 2889: 2885: 2884: 2880: 2876: 2874: 2870: 2869: 2865: 2861: 2860: 2857: 2852: 2848: 2842: 2841: 2834: 2816: 2812: 2807: 2802: 2797: 2792: 2788: 2784: 2780: 2773: 2765: 2761: 2757: 2753: 2748: 2743: 2739: 2735: 2731: 2724: 2716: 2712: 2707: 2702: 2698: 2694: 2690: 2686: 2682: 2675: 2667: 2663: 2659: 2655: 2648: 2640: 2636: 2632: 2628: 2624: 2620: 2613: 2605: 2601: 2595: 2593: 2584: 2580: 2576: 2572: 2568: 2560: 2552: 2548: 2544: 2540: 2536: 2532: 2528: 2524: 2520: 2513: 2505: 2501: 2497: 2493: 2489: 2485: 2482:(6): 354–64. 2481: 2477: 2476: 2468: 2460: 2456: 2451: 2446: 2442: 2438: 2434: 2427: 2419: 2415: 2411: 2407: 2400: 2392: 2388: 2384: 2380: 2376: 2372: 2368: 2364: 2357: 2355: 2346: 2342: 2338: 2334: 2330: 2326: 2322: 2318: 2311: 2303: 2299: 2295: 2291: 2286: 2281: 2278:(5): 476–83. 2277: 2273: 2269: 2262: 2247: 2243: 2239: 2233: 2225: 2221: 2216: 2211: 2207: 2203: 2199: 2192: 2184: 2180: 2176: 2171: 2166: 2162: 2158: 2154: 2150: 2146: 2142: 2138: 2131: 2120: 2116: 2112: 2107: 2102: 2098: 2094: 2090: 2086: 2079: 2072: 2064: 2060: 2055: 2050: 2046: 2042: 2038: 2034: 2030: 2023: 2015: 2011: 2007: 2003: 1999: 1995: 1991: 1987: 1980: 1972: 1968: 1964: 1960: 1956: 1952: 1945: 1937: 1933: 1928: 1923: 1920:(2): 113–25. 1919: 1915: 1908: 1901: 1899: 1897: 1895: 1886: 1882: 1878: 1874: 1870: 1866: 1863:(4): 771–81. 1862: 1858: 1851: 1843: 1837: 1833: 1826: 1818: 1814: 1809: 1804: 1800: 1796: 1792: 1788: 1784: 1777: 1769: 1765: 1759: 1755: 1754: 1746: 1738: 1734: 1729: 1724: 1721:(4): 239–43. 1720: 1716: 1712: 1705: 1690: 1686: 1682: 1681: 1676: 1670: 1662: 1658: 1654: 1650: 1646: 1642: 1638: 1634: 1627: 1625: 1623: 1621: 1619: 1617: 1608: 1604: 1600: 1596: 1592: 1588: 1581: 1579: 1577: 1575: 1573: 1571: 1562: 1558: 1554: 1550: 1543: 1541: 1532: 1528: 1524: 1521:(5): 383–90. 1520: 1516: 1512: 1505: 1503: 1501: 1499: 1497: 1495: 1493: 1491: 1489: 1487: 1485: 1483: 1481: 1479: 1477: 1475: 1473: 1471: 1469: 1467: 1465: 1463: 1461: 1459: 1450: 1446: 1441: 1436: 1433:(6): 425–34. 1432: 1428: 1424: 1417: 1401: 1397: 1391: 1389: 1387: 1385: 1368: 1364: 1358: 1343: 1339: 1333: 1325: 1321: 1316: 1311: 1306: 1301: 1297: 1293: 1289: 1282: 1280: 1278: 1276: 1274: 1272: 1270: 1268: 1266: 1264: 1262: 1260: 1258: 1256: 1254: 1252: 1250: 1248: 1239: 1235: 1231: 1227: 1223: 1219: 1215: 1211: 1204: 1202: 1200: 1198: 1189: 1185: 1180: 1175: 1171: 1167: 1163: 1159: 1155: 1154:"Pharyngitis" 1148: 1146: 1137: 1133: 1128: 1123: 1119: 1115: 1111: 1107: 1103: 1096: 1094: 1092: 1083: 1079: 1074: 1069: 1065: 1061: 1057: 1050: 1048: 1032: 1028: 1022: 1020: 1011: 1007: 1001: 997: 996: 988: 986: 984: 982: 973: 969: 963: 959: 958: 950: 948: 946: 944: 942: 940: 923: 919: 913: 911: 909: 907: 905: 903: 901: 899: 894: 886: 884: 875: 869: 866: 864: 861: 859: 856: 854: 851: 849: 846: 844: 841: 839: 838:Scarlet fever 836: 834: 831: 830: 828: 823:Complications 820: 811: 809: 804: 800: 796: 792: 788: 784: 782: 778: 773: 771: 767: 763: 753: 751: 750:Reye syndrome 747: 743: 739: 729: 727: 723: 712: 709: 708:Tonsillectomy 700: 698: 694: 690: 686: 682: 678: 674: 670: 666: 662: 658: 652: 642: 638: 636: 632: 628: 624: 620: 619:gold standard 616: 606: 604: 600: 595: 589: 586: 583: 580: 577: 576: 575: 572: 570: 561: 558: 555: 552: 551: 547: 544: 543: 536: 533: 532: 528: 525: 522: 521: 517: 514: 511: 510: 499: 497: 493: 492: 491:fusobacterium 487: 486: 480: 476: 475: 474:Streptococcus 454: 449: 445: 441: 437: 428: 423: 419: 410: 405: 404: 403: 401: 396: 393: 391: 387: 383: 379: 375: 371: 367: 363: 358: 356: 353:), and large 352: 348: 344: 340: 330: 328: 324: 318: 316: 312: 308: 303: 299: 295: 290: 288: 284: 279: 274: 272: 271:scarlet fever 268: 264: 260: 256: 252: 248: 247:gram-positive 244: 243: 238: 234: 230: 226: 222: 218: 214: 205: 201: 198: 194: 190: 187: 183: 179: 176: 172: 169: 165: 161: 157: 153: 149: 146: 144: 140: 137: 133: 130: 128: 124: 120: 118: 114: 111: 110: 106: 102: 98: 94: 90: 86: 82: 80: 76: 73: 70: 68: 64: 60: 55: 51: 46: 42: 38: 33: 27: 19: 4071:Human throat 3927:Pneumothorax 3880:Lung abscess 3862: 3732: 3721:Pneumocystis 3682:Pneumococcal 3463:lung disease 3459:occupational 3437:Interstitial 3402: 3346: 3332: 3305:lung disease 3271: 3265:Epiglottitis 3255: 3223: 3217:Laryngospasm 3181: 3162:Strep throat 3161: 3147: 3110: 3086:nasal septum 3084: 3043: 3027: 2942: 2931: 2907: 2892: 2877: 2862: 2838: 2786: 2782: 2772: 2737: 2733: 2723: 2691:(2): 85–91. 2688: 2684: 2674: 2657: 2653: 2647: 2622: 2618: 2612: 2566: 2559: 2522: 2518: 2512: 2479: 2473: 2467: 2440: 2436: 2426: 2409: 2405: 2399: 2369:(6): 506–8. 2366: 2362: 2320: 2316: 2310: 2275: 2271: 2261: 2250:. 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Index

Strep throat
A set of large tonsils in the back of the throat covered in white exudate
exudate
Specialty
Infectious disease
Symptoms
Group A streptococcus
Risk factors
Diagnostic method
Throat culture
strep test
Differential diagnosis
Epiglottitis
infectious mononucleosis
Ludwig's angina
peritonsillar abscess
retropharyngeal abscess
viral pharyngitis
Airborne precautions
Paracetamol
NSAIDs
antibiotics
pharyngitis
infection
pharynx
throat
Streptococcus pyogenes
gram-positive
group A streptococcus
fever

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