Main forms of streptococcal infection
The most common is acute tonsillopharyngitis: severe sore throat, fever, plaque on the tonsils, enlarged painful cervical lymph nodes in the absence of cough and runny nose. Scarlet fever is the same infection, but with a rash and a characteristic crimson tongue, found mainly in children. Erysipelas manifests itself as a bright red area of skin with clear boundaries, swelling and fever, most often on the lower leg or face. Impetigo is a superficial skin infection with honey-yellow crusts, typical of children.
- Acute tonsillopharyngitis (tonsillitis)
- Scarlet fever
- Erysipelas
- Impetigo and streptoderma
- Soft tissue phlegmon
- Postpartum and wound infections
- Streptococcal toxic shock (rare)
Symptoms of sore throat and scarlet fever
Streptococcal sore throat typically has a sudden onset: sore throat that gets worse when swallowing, temperature above 38 °C, headache, sometimes abdominal pain and vomiting in children. As a rule, there is no cough or runny nose - it is the absence of these symptoms that makes one think about a bacterial nature. With scarlet fever, on the second day a pinpoint rash appears against the background of reddened skin, thickening in the folds; the nasolabial triangle remains pale, and after a few days the tongue becomes bright crimson. Later, the skin on the palms and soles peels off in layers.
- Acute pain in the throat when swallowing
- Temperature above 38 °C
- Plaques on the tonsils
- Enlarged, painful cervical lymph nodes
- No cough or runny nose
- Pinpoint rash and crimson tongue with scarlet fever
- Peeling of palms and feet after scarlet fever
Diagnostics
A rapid antigen test in a throat swab and a classic culture help confirm the streptococcal nature. It makes sense to do a smear before starting antibiotics. A complete blood count and C-reactive protein reflect the severity of bacterial inflammation. The ASLO test is not suitable for diagnosing acute tonsillitis because antibodies develop later: it is used when complications are suspected, such as rheumatic fever or glomerulonephritis. A urine test is prescribed for monitoring after an infection.
- Rapid test for group A streptococcus
- Throat swab culture with antibiogram
- General blood test
- C-reactive protein
- ASLO for suspected complications
- General urine test after illness
- ECG and examination by a cardiologist for heart complaints
Treatment
Streptococcal sore throat is treated with antibiotics, and penicillin remains the drug of choice; In case of allergies, the doctor selects an alternative. It is fundamentally important to complete the full course, even if after two days your health has returned to normal: it is the full course that reduces the risk of rheumatic fever. Additionally, you need plenty of warm drinks, soft food, painkillers and antipyretics as prescribed. Gargles relieve pain, but do not replace antibiotics. For erysipelas and phlegmon, treatment is carried out under the supervision of a doctor, sometimes in a hospital.
- Full course antibiotic as prescribed by a doctor
- Do not stop treatment when you feel better
- Drink plenty of warm drinks and soft food
- Painkillers and antipyretics by age
- Rinsing as an auxiliary measure
- Bed rest during the first days of fever
- Control urine test after recovery
Complications and prevention
Early complications are associated with the spread of pus: peritonsillar abscess, otitis media, sinusitis, lymphadenitis. Late ones develop weeks after infection and are of an immune nature: acute rheumatic fever with damage to the heart and joints and acute glomerulonephritis with edema and changes in the urine. It is to prevent them that a full course of antibiotics is needed. Household prevention: do not share utensils, wash your hands, isolate the sick person for the duration of the fever and the first day of treatment.
- Peritonsillar abscess
- Otitis media and sinusitis
- Cervical lymphadenitis
- Acute rheumatic fever
- Acute glomerulonephritis
- Isolation of the sick person in the first days
- Separate dishes and towels
- Hand washing and ventilation