Strep Throat (GAS) (cont.)

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What are the signs and symptoms of strep throat?

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:

Of note is the fact that runny nose, cough, hoarse voice, muscle aches, diarrhea and 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
  • Enlarged and tender neck lymph nodes (also known as lymph glands), and occasionally
  • 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 scarlet 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 individual.

Are the signs and symptoms of strep throat different in various age groups?

The information listed above is seen in those most likely to have a strep throat infection - individuals that are older children and teenagers. However, other age groups may experience a different constellation of findings with a strep throat infection.

  • Infants: more commonly have a thick purulent nasal discharge, low grade fever (< 101 F [38.33 C]), reduction in appetite and fussiness.
  • Toddlers: children from one to three years of age may complain of a sore throat, have pain with swallowing and subsequently a limited appetite, and swollen lymph nodes (lymph glands) beneath the mandible (lower jaw bone).
  • Adults: strep throat may have milder symptoms and thus may not prompt a medical evaluation unless an exposure history to strep throat is known.
Medically Reviewed by a Doctor on 10/4/2013

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