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November 25, 2009
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Rapid Strep Test

Medical Author: John Mersch, MD, FAAP
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

Overview of streptococcal throat infection

The incidence of sore throats (pharyngitis) varies with season, age of the patient, and geographic area. Sore throats can be caused by infection from viruses or bacteria. Fewer than a third of all pharyngitis is bacterial, most commonly from Group A streptococcus infection. Children 5 years to 15 years of age are the common age group affected with infection during winter/early spring season the most common season.

The pediatric population may have different presentations such as:

  1. infants (< 1 year of age) low grade fever (< 101 F, 38 C), fussiness, decreased appetite, and often exposure to either daycare or older infected siblings;

  2. children (< 3 years of age) prolonged purulent nasal discharge, low grade fever, and enlarged and tender lymph nodes in the neck area; and

  3. children (> 3 years of age) sudden onset sore throat, moderate fever (> 101 F, 38 C), headache, upset stomach, and enlarged and tender lymph nodes in the neck area.

The majority of sore throats (70% - 85%), then, are causes by viruses. Representative examples are:

  • EBV (Ebstein-Barr virus) and CMV (cytomegalic inclusion virus) which may produce a mononucleosis symptom complex,

  • adenovirus (which may be associated with conjunctivitis ("pink eye"),

  • influenza, and

  • miscellaneous others - herpes, rhinovirus (cause of the common "cold"), etc.

Unfortunately, no single characteristic element of either the patient's history or physical exam discriminates between strep and non-strep pharyngitis. Thus, the importance of laboratory evaluation since strep throat should be treated with antibiotics, while relief of symptoms remains the mainstay of treatment for viral sore throats.



Next: What is a rapid strep test? »

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Rapid Strep Test

What is rheumatic fever?

Rheumatic fever (acute rheumatic fever or ARF) is an autoimmune disease that may occur after a group A streptococcal throat infection that causes inflammatory lesions in connective tissue, especially that of the heart, joints, blood vessels, and subcutaneous tissue. The disease has been described since the 1500s, but the association between a throat infection and rheumatic fever symptom development was not described until the 1880s. It was associated with scarlet fever (rash caused by streptococcal exotoxins) in the 1900s. Prior to the broad availability of penicillin, rheumatic fever was a leading cause of death in children and one of the leading causes of acquired heart disease in adults. The disease has many symptoms and can affect different parts of the body, including the heart, joints, skin, and brain. There is no simple diagnostic test for rheumatic fever, so the American Heart Association's modified Jones criteria (f...

Read the Rheumatic Fever article »










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