A strep infection is a contagious bacterial infection that develops in the throat. Hundreds of millions of cases are diagnosed each year worldwide. Although this disease is more common in children and immunocompromised people than in healthy adults, it can strike at any age. The only way to know for sure if you have a strep infection is to see a doctor and get examined. If you want to know if you have a strep infection before you make an appointment, there are several symptoms to recognize.
Method 1 of 4: Assessing symptoms in the throat and mouth
Step 1. Determine how severe the sore throat is
Severe sore throat is usually one of the first signs of a strep infection. You can also have a strep infection if you only have a moderate sore throat, but a mild sore throat that goes away easily or can be relieved is usually not caused by a strep infection.
- You don't just have pain when you talk or swallow.
- If you can ease the pain with painkillers or cold drinks, it could still be a strep infection, but it's impossible to completely get rid of the pain without prescription medications.
Step 2. Try to swallow
If you only have a moderate sore throat, which becomes very painful when you swallow, it could be a strep infection. The pain can make it difficult to swallow if you have a strep infection.
Step 3. Smell your breath
While not all patients suffer from foul breath, a streptococcal infection often causes noticeable foul-smelling breath. This is due to the bacteria multiplying.
- Although it smells strongly, the exact scent can be difficult to describe. Some people think it smells like iron or hospital, while others liken it to rotting flesh. Whatever you call it, the breath smells stronger and dirtier than usual with a strep infection.
- Since "bad breath" is a subjective term, it's not really a way to diagnose a strep infection, but rather something associated with it.
Step 4. Feel the glands in your neck
Lymph nodes trap germs to destroy them. The lymph nodes in your neck are usually swollen and tender to the touch when you have a strep infection.
- Although you may have lymph nodes in several areas of your body, the nodes closest to the source of infection will usually swell first. In the case of a streptococcal infection, these are the lymph nodes in and around the neck.
- Gently feel just below your ears with your fingertips. Move your fingers behind your ears in circular motions.
- Also check the area of your throat just below your chin. The place where your lymph nodes usually swell as a result of a strep infection is under your jaw, between your chin and your ear. Move your fingertips back and forth to your ear and then to the side of the neck below your ear.
- Finally, feel your collarbones on both sides.
- If you feel significant swelling in any of these areas, your lymph nodes may be swollen due to a strep infection.
Step 5. Check your tongue
People with a strep infection often have a stinging layer of small red dots on their tongue, especially in the back of the mouth. Most people compare this layer to the surface of a strawberry.
These red dots can be bright red or dark red. Usually it looks inflamed
Step 6. Look at the back of your throat
Many people who suffer from a strep infection have petechiae, red dots on the soft or hard palate (the top of the mouth, at the very back).
Step 7. Check your tonsils, if you still have them
A strep infection can inflame the tonsils. They become redder, and usually they are noticeably larger than normal. Sometimes you can also see that the tonsils are covered with white spots. These spots are on the tonsils or in the back of the throat. They can also be yellow instead of white.
There may also be long streaks of white pus on your tonsils, rather than white patches. This is another symptom of a strep infection
Method 2 of 4: Assessing other common symptoms
Step 1. Consider if you've been around someone with a strep infection
The infection is highly contagious and can be spread through direct contact with the bacteria that causes it. It is very unlikely that you will get a strep infection without being in contact with someone who is infected.
- It can be very difficult to know if someone else has a strep infection. Unless you have been completely isolated, you will probably have been in contact with someone who has the infection.
- Someone can also have passed on the streptococcal infection without experiencing any symptoms.
Step 2. Consider how quickly the disease came on
A sore throat from a strep infection often develops without warning and gets worse quickly. If your throat became increasingly sore over a few days, it probably has another cause.
However, that doesn't mean it can't be a strep infection
Step 3. Take your temperature
A streptococcal infection is usually accompanied by a fever of 38.5ºC or higher. If you have a lower fever, it could still be a strep infection, but it's more likely a symptom of a viral infection.
Step 4. Watch out for headaches
Headaches are another common symptom of a streptococcal infection. It can range from mild to very severe.
Step 5. Keep an eye out for digestive problems
If you have no appetite or are nauseous, that could also be a sign of strep infection. In the worst cases, a strep infection can also lead to vomiting and abdominal pain.
Step 6. Take fatigue into account
As with any infection, a strep infection can lead to fatigue. You may find it difficult to wake up in the morning and stay fit throughout the day.
Step 7. Check if you have a rash
A severe strep infection can cause scarlet fever. This red rash looks and feels like sandpaper.
- Scarlet fever usually sets in 12 to 48 hours after the first symptoms of a strep infection.
- The rash usually starts around the neck before spreading across the chest. It can also spread over the abdomen and pubic area. In rare cases, it can also appear on the back, arms, legs and face.
- Scarlet fever usually disappears quickly when treated with antibiotics. If you see this type of rash, you should see your doctor as soon as possible, whether or not you experience other symptoms of a strep infection.
Step 8. Notice which symptoms you don't have
While the common cold and a strep infection share many of the same symptoms, there are several cold-like symptoms that people with a strep infection do not have. The absence of these symptoms may indicate that you have a strep infection, not a cold.
- With a streptococcal infection you usually have no symptoms on the nose. That means you don't have a stuffy nose, runny nose, cough, or red, itchy eyes.
- In addition, a streptococcal infection sometimes causes abdominal pain, but usually no diarrhea.
Method 3 of 4: Assessing your recent history and risk factors
Step 1. Research your medical history
Some people are more susceptible to a strep infection than others. If you have suffered from a streptococcal infection before, it is likely that the new infection is too.
Step 2. Assess whether your age makes it plausible that you have a streptococcal infection
Although 20-30% of sore throats in children are streptococcal, only 5-15% of adults see a doctor with a sore throat.
The elderly and people with an underlying illness (such as the flu) are more susceptible to infection
Step 3. Find out if your situation increases the risk of a strep infection
You are more likely to get a strep infection if another family member has had a strep infection in the past two weeks. Shared living or playing areas such as schools, nurseries, dormitories and military barracks are examples of environments where bacterial colonization is possible.
Although children are more at risk for a strep infection, babies under the age of 2 are less likely to get infected. However, they may not have the usual symptoms that older children and adults do. They may have a fever and runny nose, cough and have a loss of appetite. Ask your doctor if your baby is at risk of getting a strep infection if you or someone close to you has it, with a fever or other symptoms
Step 4. Assess whether there are certain risk factors that make you more susceptible to a strep infection
People with weakened immune systems, making them less able to fight infection, may be at higher risk. Other infections or illnesses can also increase the chance of a strep infection.
- Even fatigue can already weaken your immune system. Exhaustion or strenuous activities (such as running a marathon) can also be an attack on your body. Because your body is focused on recovery, it can hinder its ability to fight off an infection. Simply put, an exhausted body is focused on recovery, so it can't protect itself efficiently enough.
- Smoking can damage the protective mucous membranes in the mouth, making it easier for bacteria to colonize.
- Oral sex can also make your oral cavities more susceptible to bacteria.
- Diabetes reduces your body's ability to fight off infections.
Method 4 of 4: To the GP
Step 1. Know when to see the doctor
You don't always have to see a doctor if you have a sore throat, but some symptoms should be enough to worry you to make an appointment right away. If, in addition to a sore throat, you have swollen lymph nodes, a rash, difficulty swallowing or breathing, a high fever or a fever longer than 48 hours, call your doctor for an appointment.
Also see a doctor if you have a sore throat for more than 48 hours
Step 2. Let your doctor know you are concerned
Bring a list of all your symptoms and say you suspect you have a strep infection. The GP will then usually check whether these are indeed symptoms of this disease.
- Your doctor will probably take your temperature.
- He or she will look down your throat with a light. He/she will also want to see if your tonsils are swollen, if you have a red rash on your tongue, and if there are white or yellow spots in the back of your throat.
Step 3. Have your doctor follow a protocol for a clinical diagnosis
This protocol is a structured way to assess symptoms. Your GP will probably follow the NHG standard for acute sore throat. The NHG Standard Acute Sore Throat provides guidelines for the diagnosis and management of sore throat that has existed for less than fourteen days and where an infectious cause is assumed.
- The best known method is the centor score. The doctor gives positive or negative points for signs and symptoms: +1 point for milky white spots on the tonsils, +1 point for tender lymph nodes, +1 point for fever, +1 point if the patient is under 15 years old, + 0 for ages 15-45, -1 point for over 45, and -1 for cough.
- If the score is between 3-4 points, there is an 80% chance that you have a group A streptococcal infection. That means the result is positive. The infection must then be treated with antibiotics, and your doctor will prescribe the appropriate treatment.
Step 4. Ask your doctor about a rapid strep test
Research has shown that individual or combined symptoms predict the presence of the streptococcal bacteria as a cause of acute sore throat with limited reliability. A rapid antigen test can be performed in a general practice and only takes a few minutes.
The doctor uses a cotton swab to scrape some liquid from the back of the throat. This fluid is immediately examined and within 5 to 10 minutes you will receive the result
Step 5. Ask the doctor for a throat culture
If the rapid test result is negative, but you have other symptoms of a strep infection, your doctor may want to do a more extensive test, known as a throat culture. A throat culture is an attempt to colonize the bacteria outside the throat in the laboratory. If the bacterial colony multiplies outside your throat, it is easier to detect larger groups of streptococcal bacteria. The doctor will likely use a combination of the centor score, a rapid strep test, and a throat culture, depending on his or her clinical judgment.
- Although you can usually decide whether the streptococcal bacteria is present with the rapid test, false negative results are also known. For example, a throat culture is much more accurate.
- A throat culture is not necessary if the rapid test is positive, because the rapid test tests directly for antigens on the bacteria, and only gives a positive result if a certain amount of bacteria is present. This indicates that immediate treatment with antibiotics is necessary.
- The doctor takes a little liquid from the back of the throat with a cotton swab. This is sent to the lab where the liquid is transferred to an agar plate. Then follows an incubation period of 18 to 48 hours, depending on the method used by this particular laboratory. If you have a strep infection, the group A strep bacteria will grow on the dish.
Step 6. Learn about other studies
Some doctors prefer a Nucleic Acid Amplification Test (NAAT) over throat culture if the rapid test is negative. This test is accurate and gives results within a few hours, as opposed to the 1 to 2 day incubation period required by the seedling culture.
Step 7. Take antibiotics if your doctor prescribes them
Streptococcal infection is a bacterial infection that can be effectively treated with antibiotics. If you know that you are allergic to certain antibiotics (such as penicillin for example), it is important that you let your doctor know so that he/she can provide a suitable alternative.
- Usually, a course of antibiotics lasts up to 10 days (depending on the type of antibiotics your doctor prescribes). Make sure to finish the course, even if you feel better before you're done.
- Penicillin, Amoxicillin, Cephalosporins, and Azithromycin are all types of antibiotics prescribed to treat an infection. Penicillin is often used for a streptococcal infection. However, there are people who are allergic to this remedy. Let your doctor know if this is the case for you. Amoxicillin also works well against a streptococcal infection. It is similar to penicillin in effectiveness, and it can resist stomach acid better so it is more easily absorbed into your system. In addition, it has a broader spectrum than penicillin.
- Azithromycin, Erythromycin, or cephalosporins are often given as an alternative to penicillin if the patient is allergic to them. Note that Erythromycin is more likely to cause side effects to the digestive system.
Step 8. Make yourself comfortable and rest while the antibiotics do their work
Usually the recovery takes as long as the course of antibiotics (maximum 10 days). Give your body the opportunity to recover.
- Extra sleep, herbal teas, and plenty of water will help ease the sore throat while you recover.
- Eating cold drinks and popsicles can also help to ease the pain.
Step 9. Check with your doctor if necessary
After a day or 2-3 you should start to feel better; if not, or if you still have a fever, call your doctor. If you appear to be having an allergic reaction to the antibiotics, call your doctor immediately. Signs of an allergic reaction include a rash, chills, or swelling after you take the antibiotics.
- Stay at home for at least 24 hours after starting treatment for the strep infection.
- Do not share cups, utensils, or body fluids with people who have a strep infection.
- A strep infection should be treated with antibiotics. Otherwise, rheumatic fever can develop, a serious disease that can affect the heart and joints. This condition can develop 9 to 10 days after the first symptoms, so prompt action is advised.
- See your doctor right away if you can't swallow liquids, show signs of dehydration, can't swallow your own saliva, or have severe neck pain or stiffness.
- Note that mononucleosis can have similar symptoms to a streptococcal infection, or it can occur alongside a streptococcal infection. If you get a negative result after a strep test but the symptoms remain and you are extremely tired, ask your doctor to test for mononucleosis.
- If you've been treated for a strep infection, call your doctor if your urine turns the color of Coke, or if you're producing less urine. That could mean you have kidney inflammation, which is a possible complication of a strep infection.