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.
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.
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.
Strep throat is a bacterial infection of the soft palate and tonsillar
region. Microbiologists specifically identify the member of the
Streptococcus bacterial family that causes strep throat as "GAS" (Group A, beta
hemolytic, streptococcus pyogenes). Strep throat is most common in young
children and adolescents, but it is not unusual in toddlers and adults. It
is highly contagious and it is present most commonly in the community during the
winter months. Interestingly, the symptoms and physical signs may vary
depending upon the age of the infected patient.
Signs of strep throat are not unique - indeed many viral infections (which
cause the large majority of sore throats) can have identical signs and symptoms
as a GAS infection. Typically, an older child and adolescent will have
several core symptoms:
Upset stomach with nausea occasionally severe enough to cause mild
Of note is the fact that runny nose, cough,
hoarse voice, muscle aches,
oral blisters are generally not seen with a laboratory confirmed
strep throat infection. These latter symptoms are more commonly indicative
of a sore throat caused by a virus.
Physical examination with a strep throat infection will commonly demonstrate:
Redness of the soft palate, uvula (the "punching bag" structure hanging
from the back of the soft palate) and tonsils
A purulent discharge on the tonsils (exudate)
Petechiae (1-2 mm bright red "dots" which represent ruptured
capillaries) scattered on the soft palate
A diffuse rash over the torso and groin region. The classic
description of this rash is that of "goose bumps on a moderate sunburn."
The presence of a strep infection and this specific rash is termed
fever. Such a diagnosis does not imply a more severe GAS infection or
imply any change in prognosis or management. The rash is not contagious.
It is important to note that while most patients with strep throat will
experience these signs and symptoms, not all will necessarily be present in each
Reviewed by William C. Shiel Jr., MD, FACP, FACR on 10/4/2013
Throat infection with strep bacteria is contagious and can cause a variety of symptoms
associated with inflammation of the throat and its nearby structures. Symptoms
usually begin within a few days (1-4 days) after contracting the infection
Typical signs of strep throat infection are:
swollen, tender lymph nodes on the sides of the neck;
white patches seen on the tonsils and throat.
Some other more non-specific signs and symptoms of strep throat which can
also be seen in strep throat due to other causes are: