1. Just a Sore Throat or Strep Slideshow
2. Take the Strep Throat Infection Quiz!
3. Infectious Mononucleosis Slideshow

Medical Author:

John Mersch, MD, FAAP

John Mersch, MD, FAAP

Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• Strep throat facts
• What is strep throat?
• What causes a sore throat?
• What are tonsils and tonsillitis?
• What are pharynx and pharyngitis?
• Viral causes of throat infection
• Bacterial causes of throat infection
• How common is strep throat?
• Is strep throat contagious?
• What are the signs and symptoms of strep throat?
• Are strep throat symptoms different in children compared to adults?
• When should I be concerned about a possible strep throat?
• How is strep throat diagnosed?
• Who should be tested for strep throat?
• How is strep infection treated?
• How can viral throat infection be treated?
• Are there any recommended strep throat remedies and symptom reducers?
• When should the tonsils be removed?
• Why is it very important to detect and treat a strep throat?
• What are the potential complications of untreated strep throat infection?
• Is there a vaccine for strep throat?
• Can strep throat be prevented?
• Just a Sore Throat or Strep - Slideshow
• Take the Strep Throat Infection Quiz!
• Infectious Mononucleosis - Slideshow
• Strep Throat (Streptococcal) Infection FAQs
• Patient Comments: Strep Throat - Diagnosis
• Patient Comments: Strep Throat - Treatment
• Patient Comments: Strep Throat - Home Remedies for Symptoms
• Patient Comments: Strep Throat - Length Symptoms Lasted
• Strep Throat Index

During the doctor's physical examination, a throat culture might be taken by touching a soft cotton swab (similar to a Q-tip) to the throat and tonsil areas. The swab is then sent to the laboratory for evaluation of strep or other bacteria. After 24-48 hours, the rapidly-growing strep bacteria can be identified if present in the sample. A throat culture is the gold standard in diagnosing strep throat infection.

A culture for strep throat should not be done as a screening test in an individual who is experiencing no symptoms suggestive of strep throat. This is because bacteria may be present without causing an infection. A person may be a carrier of the bacteria but not infected.

Rapid strep tests (also called the Rapid Antigen Detection Test or RADT) are available that can give results in minutes. A sample from the back of the throat or tonsils is taken using a swab similar to the sample for culture. Using a RADT kit, the doctor can determine within a few minutes if strep is the likely cause of sore throat. This test is less precise than throat cultures.

Most RADT tests are approximately 95% accurate in diagnosing strep throat. This implies a "false negative" rate of 5%. In such circumstances the more definitive throat culture should be obtained. If your health care professional has a high suspicion for strep throat, both tests (RADT and throat culture) may be performed, and treatment should be started as soon as possible even if the rapid test is negative for strep while waiting for the definitive culture results. If the throat culture is negative for strep infection, then antibiotics should be stopped.

Taking any "self prescribed" antibiotic prior to seeing the doctor should be avoided because even a single dose of antibiotic can interfere with the culture results and the health care practitioner's ability to correctly diagnose and treat the infection.

Streptococcus infection can be detected by measuring the antibodies produced by the body against the bacteria. Two blood tests are most commonly used: (a) ASO titer (anti streptolysin O) and (b) anti DN-ase B titer. These antibodies may not be present in the blood for a few weeks after an infection, and therefore their measurement may not be accurate to detect an active or acute infection. ASO and anti-DN-ase B titers also may not be detectable if the person had been appropriately treated with antibiotics.

These tests may be useful in detecting prior infections and evaluating a person with complications of strep throat infection such as rheumatic fever or glomerulonephritis (see below).