The question: I’ve had a sore throat for a few days. How do I know if I have strep and need antibiotics?
A sore throat (pharyngitis) is among the most common reasons that people seek medical attention. Pharyngitis can be caused by a variety of illnesses or medical conditions, like viruses, bacteria (strep), seasonal allergies, acid reflux or even sexually transmitted infections.
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Viral illnesses are by far the most common cause of sore throats. Hundreds of cold viruses are responsible for millions of sore throats every year, especially in winter and early spring. These outnumber strep by approximately 10 to 1, are often accompanied by nasal congestion and/or a cough, and a low-grade fever and general malaise. White spots on your tonsils and swollen glands are not findings that are specific to strep — they’re just as likely to be found with viral infections.
Strep, short for beta-hemolytic streptococcus group A (quite the mouthful!) is a bacteria that causes sore throats, and is usually accompanied by fever, chills and general discomfort. A strep infection can be diagnosed with a rapid antigen test that looks for evidence of the bacteria by taking a swab of mucous from the back of your throat. It has a successful detection rate of about 90 percent in adults, but the test is somewhat less accurate in children. If your test is negative, it’ll be sent out to a lab for confirmation.
Strep infections should be treated with an appropriate antibiotic such as amoxicillin or another antibiotic in case of a penicillin allergy. This will make the symptoms clear up a few days sooner than without antibiotics, and more importantly, limit the likelihood of complications caused by this type of strep infection. Scarlet fever, rheumatic fever and kidney inflammation (can you say glomerulonephritis?) are all very preventable side effects of strep infections when treated with antibiotics.
Strep and sore throat viruses are contagious. If you’re infected, wash your hands frequently and avoid intimate contact (like kissing, etc.) until two to three days after a fever is gone, or antibiotics have been initiated.
Infectious mononucleosis and herpes canker sores are other sore throat viruses and can be diagnosed by specific testing once strep has been ruled out. Acid reflux and post-nasal drip from seasonal allergies or sinus infections are also common sources of sore throats and can be treated accordingly by your physician.