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Encyclopedia > Strep throat
Strep throat
Classification & external resources
Strep throat
ICD-10 J02.0
ICD-9 034.0

Strep throat (or "Streptococcal pharyngitis", or "Streptococcal Sore Throat") is a form of Group A streptococcal infection that affects the pharynx. Image File history File links PHIL_3183_lores. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // J00-J99 - Diseases of the respiratory system (J00-J06) Acute upper respiratory infections (J00) Acute nasopharyngitis (common cold) (J01) Acute sinusitis (J02) Acute pharyngitis (J03) Acute tonsillitis (J04) Acute laryngitis and tracheitis (J05) Acute obstructive laryngitis (croup) and epiglottitis (J050) Acute obstructive laryngitis (croup) (J051) Acute epiglottitis (J06) Acute upper... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Streptococcus is a genus of spherical shaped Gram-positive bacteria, belonging to the phylum Firmicutes[1] and the lactic acid bacteria group. ... ÏŽ:For the noisegrind band, see Sore Throat. ... The group A streptococcus bacterium (Streptococcus pyogenes, or GAS) is a form of Streptococcus bacteria responsible for most cases of streptococcal illness. ... The pharynx (plural: pharynges) is the part of the neck and throat situated immediately posterior to the mouth and nasal cavity, and cranial, or superior, to the esophagus, larynx, and trachea. ...

Contents

Symptoms

  • Sore throat
  • Red and Black patches in the throat.
  • Difficulty swallowing
  • Tender cervical lymphadenopathy
  • Red and enlarged tonsils
  • Halitosis
  • Fever of 101 F/38C or greater
  • Rash [1]
  • Frequent cold chills
  • Absence of cough
  • White spots on tonsils
  • Desquamation (peeling skin on fingertips) a few weeks after treatment

This article does not cite any references or sources. ... The Palatine tonsils. ... Halitosis, oral malodor (scientific term), breath odor, foul breath, fetor oris, or most commonly bad breath are terms used to describe noticeably unpleasant odors exhaled in breathing – whether the smell is from an oral source or not. ... This article needs additional references or sources for verification. ...

Diagnosis

Signs and symptoms

A study of 729 patients with pharyngitis in which 17% had a positive throat culture for group A streptococcus, identified the following four best predictors of streptococcus[2]:


1. Lack of cough

2. Swollen tender anterior cervical nodes 3. (Marked) tonsillar exudates. Although the original study did not specify the degree of exudate, 'marked exudate' may be more accurate. A subsequent study of 693 patients with 9.7% having positive cultures found that 'marked exudates' had a sensitivity and specificity of 21% and 70% while 'pinpoint exudates' were nonspecific with sensitivity and specificity of 22% and 45%[3]. The sensitivity of a binary classification test or algorithm, such as a blood test to determine if a person has a certain disease, or an automated system to detect faulty products in a factory, is a parameter that expresses something about the tests performance. ... The specificity is a statistical measure of how well a binary classification test correctly identifies the negative cases, or those cases that do not meet the condition under study. ...

4. History of fever The sensitivity of a binary classification test or algorithm, such as a blood test to determine if a person has a certain disease, or an automated system to detect faulty products in a factory, is a parameter that expresses something about the tests performance. ... The specificity is a statistical measure of how well a binary classification test correctly identifies the negative cases, or those cases that do not meet the condition under study. ...

5.hurts when swallowing. The sensitivity of a binary classification test or algorithm, such as a blood test to determine if a person has a certain disease, or an automated system to detect faulty products in a factory, is a parameter that expresses something about the tests performance. ... The specificity is a statistical measure of how well a binary classification test correctly identifies the negative cases, or those cases that do not meet the condition under study. ...


When these findings are counted in a patient, the probabilities of positive cultures in the original study (prevalence=17%) are[2]:

  • 4 findings -> 55.7%
  • 3 findings -> 30.1 – 34.1%
  • 2 findings -> 14.1 – 16.6%
  • 1 findings -> 6.0 - 6.9%
  • 0 findings -> 2.5%

The probabilities can also be computed with the following equation: X = −2.69 + 1.04 (exudtons) + 1 (swolacn) - 0.95 (cough) + 0.89 (fevhist)


Tests

The throat of the patient is swabbed for culture or for a rapid strep test (5 to 10 min) which can be done in the doctor's office. A rapid test tests for the presence of antibodies against the bacteria. If the rapid test is negative, a follow-up culture (which takes 24 to 48 hours) may be performed. A negative culture suggests a viral infection, in which case antibiotic treatment should be withheld or discontinued. This article is about biological infectious particles. ... Staphylococcus aureus - Antibiotics test plate. ...


A doctor will most likely prescribe Amoxicilin a.k.a Novamoxin. Amoxicillin (INN) or amoxycillin (former BAN) is a moderate-spectrum β-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. ...


Transmission

The illness is caused by the bacterium Streptococcus pyogenes and is spread by direct, close contact with an infected person via respiratory droplets (cough or sneezing). Casual contact rarely results in transmission. Rarely, contaminated food, especially milk and milk products, can result in outbreaks. Untreated patients are most infectious for 2-3 weeks after onset of infection. The incubation period, the period after exposure and before symptoms show up, is difficult to establish as some people don't become symptomatic. However, it is thought to be between two and five days. Strep is caused by bacteria of a type called group A beta-hemolytic streptococci. Symptoms include sore throat, fever, headache, and in some cases, chills, nausea, and vomiting. The patient usually experiences swelling of the tonsils and lymph nodes in the neck. Binomial name Streptococcus pyogenes Rosenbach 1884 Streptococcus pyogenes is a Gram-positive coccus that grows in long chains depending on the culture method. ... For other uses, see Sneeze (disambiguation). ... A glass of cows milk. ... Dairy products are generally defined as foodstuffs produced from milk. ... Virus outbreaks occur when a virus bypasses infection control measures and a relatively high number of infections are observed where no cases or sporadic cases occurred in the past. ... Incubation period, also called the latent period or latency period, is the time elapsed between exposure to a pathogenic organism, or chemical or radiation, and when symptoms and signs are first apparent. ...


Treatment

Treatment will reduce symptoms slightly, minimize transmission, and reduce the likelihood of complications. Treatment consists of penicillin (orally for 10 days; or a single intramuscular injection of penicillin G). Erythromycin is recommended for penicillin-allergic patients. Second-line antibiotics include amoxicillin, clindamycin, and oral cephalosporins. Although symptoms subside within 4 days even without treatment, it is very important to start treatment within 10 days of onset of symptoms, and to complete the full course of antibiotics to prevent rheumatic fever, a rare but serious complication. Other complications that can occur include an ear infection, sinus infection, acute glomerulonephritis, or an abscess on the tonsils (peritonsillar abscess). For the Japanese rock band, see Penicillin (band). ... Erythromycin is a macrolide antibiotic which has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people who have an allergy to penicillins. ... An allergy is an abnormal, acquired sensitivity to a given substance, including pollen, drugs, or numerous environmental triggers. ... Amoxicillin (INN) or amoxycillin (former BAN) is a moderate-spectrum β-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. ... Clindamycin (rINN) (IPA: ) is a lincosamide antibiotic used in the treatment of infections caused by susceptible microorganisms. ... The cephalosporins, are a class of β-lactam antibiotics. ... Rheumatic fever is an inflammatory disease which may develop after a Group A streptococcal infection (such as strep throat or scarlet fever) and can involve the heart, joints, skin, and brain. ... Otitis media (also known as glue ear) is an inflammation of the middle ear, usually associated with a buildup of fluid. ... Sinusitis is an inflammation, either bacterial, viral or allergic, of the paranasal sinuses. ... Glomerulonephritis is a primary or secondary autoimmune renal disease featuring inflammation of the glomeruli. ...


According to a meta-analysis in Pediatrics, the overall summary odds ratio (OR) for the bacteriologic cure rate significantly favored cephalosporins compared with penicillin (OR: 3.02; 95% confidence interval [CI]: 2.49 –3.67, with the individual cephalosporins [cephalexin, cefadroxil, cefuroxime, cefpodoxime, cefprozil, cefixime, ceftibuten, and cefdinir] showing superior bacteriologic cure rates). The overall summary OR for clinical cure rate was 2.33 (95% CI: 1.84 –2.97), significantly favoring cephalosporins. [4]. Pediatrics is an official peer-reviewed journal of the American Academy of Pediatrics. ...


Penicillins should be avoided for treatment of a sore throat if bacterial (swab) confirmation has not been obtained since it causes a distinctive rash if the true illness proves to be viral.[citation needed] This rash is harmless but alarming. The most common virus responsible for strep-like symptoms is glandular fever, also known as mononucleosis. Typically, antibiotics such as clindamycin or clarithromycin will be prescribed if there is any doubt as to whether the infection is bacterial as it does not cause a rash in the presence of a virus. Infectious mononucleosis (also known as mono, the kissing disease, Pfeiffers disease, and, in British English, glandular fever) is a disease seen most commonly in adolescents and young adults, characterized by fever, sore throat and fatigue. ... Infectious mononucleosis (also known as mono, the kissing disease, Pfeiffers disease, and, in British English, glandular fever) is a disease seen most commonly in adolescents and young adults, characterized by fever, sore throat and fatigue. ... Clindamycin (rINN) (IPA: ) is a lincosamide antibiotic used in the treatment of infections caused by susceptible microorganisms. ... Clarithromycin is a macrolide antibiotic used to treat pharyngitis, tonsillitis, acute maxillary sinusitis, acute bacterial exacerbation of chronic bronchitis, pneumonia (especially atypical pneumonias associated with Chlamydia pneumoniae or TWAR), skin and skin structure infections, and, in HIV and AIDS patients to prevent, and to treat, disseminated Mycobacterium avium complex (MAC). ...


In addition to taking antibiotics, other ways to relieve strep symptoms include taking nonprescription medications (such as ibuprofen and acetaminophen/paracetamol) for throat pain and fever reduction, and getting plenty of rest. Also, gargling with warm saltwater (1/4 teaspoon of table salt in 8 oz. warm water) can help relieve throat pain as well as warm, plain tea. Avoid orange juice or other citrus drinks. The acids in them may irritate the throat. Ibuprofen (INN) (IPA: ) (from the earlier nomenclature iso-butyl-propanoic-phenolic acid) is a non-steroidal anti-inflammatory drug (NSAID) originally marketed as Nurofen and since under various trademarks including Act-3, Advil, Brufen, Dorival, Herron Blue, Panafen, Motrin, Nuprin and Ipren or Ibumetin (Sweden), Ibuprom (Poland), IbuHEXAL, Moment (Italy... Acetaminophen (USAN) or paracetamol (INN), is a popular analgesic and antipyretic drug that is used for the relief of fever, headaches, and other minor aches and pains. ... Paracetamol (INN) (IPA: ) or acetaminophen (USAN), is the active metabolite of phenacetin, a so-called coal tar analgesic. ...


Lack of Treatment

The symptoms of strep throat usually improve even without treatment in five days, but the patient is contagious for several weeks. Lack of treatment or incomplete treatment of strep throat can lead to various complications. Some of them may pose serious health risks.


Infectious complications

  • The active infection may occur in the throat, skin, and in blood.
  • Skin and soft tissues may become infected, resulting in redness, pain, and swelling. Skin and deep tissues may also become necrotic (rare).
  • Scarlet fever is caused by toxins released by the bacteria.
  • Rarely, some strains may cause a severe illness in which blood pressure is reduced and lung injury and kidney failure may occur (toxic shock syndrome).

Noninfective complications Look up strain in Wiktionary, the free dictionary. ... A sphygmomanometer, a device used for measuring arterial pressure. ... Renal failure is when the kidneys fail to function properly. ...

  • During the infection, antibodies (disease–fighting chemicals) are produced. *Rare complication can result after the organism is cleared, when these antibodies cause disease in body organs.
  • Rheumatic fever is a heart disease in which the inflammation of heart muscle and scarring of heart valves can occur.
  • Glomerulonephritis is a kidney disease in which the injury may lead to kidney failure.[5]

Wikipedia does not yet have an article with this exact name. ... Rheumatic fever is an inflammatory disease which may develop after a Group A streptococcal infection (such as strep throat or scarlet fever) and can involve the heart, joints, skin, and brain. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... In anatomy, the heart valves are valves in the heart that prevent blood from flowing the wrong way. ... Glomerulonephritis is a primary or secondary autoimmune renal disease featuring inflammation of the glomeruli. ...

See also

Panda can have several different meanings: The Giant Panda is a large black-and-white bear-like mammal native to China. ... Tonsillitis is an inflammation of the tonsils in the mouth and will often, but not necessarily, cause a sore throat and fever. ... ÏŽ:For the noisegrind band, see Sore Throat. ...

References

  1. ^ Kids Health
  2. ^ a b Centor RM, Dalton HP, Campbell MS, Lynch MR, Watlington AT, Garner BK. Rapid diagnosis of streptococcal pharyngitis in adult emergency room patients. J Gen Intern Med. 1986 Jul-Aug;1(4):248-51. PMID 3534175
  3. ^ Komaroff AL, Pass TM, Aronson MD, Ervin CT, Cretin S, Winickoff RN, Branch WT Jr. The prediction of streptococcal pharyngitis in adults. J Gen Intern Med. 1986 Jan-Feb;1(1):1-7. PMID 3534166
  4. ^ PMID 15060239
  5. ^ EMedicineHealth

world book encyclopedia


External links

  • Group A Streptococcal Infections - National Institute of Allergy and Infectious Diseases.
  • Post-infectious glomerulonephritis - mayoclinic.com.

  Results from FactBites:
 
HON Mother & Child Glossary, Viral Infections in Childhood: Strep Throat (457 words)
Strep throat is a throat infection caused by the group A ß-hemolytic streptococcus bacteria.
Strep throat infections are contagious and strep bacteria commonly pass from person to person in the fluid droplets of coughs and sneezes.
Strep throat is the most common type of throat infection caused by bacteria, and it tends to affect children between 5 and 15 years old.
Strep Throat (746 words)
Strep throat is an infection caused by group A streptococcus bacteria, and it's very common among kids and teens.
If your child is not treated for strep throat, he or she is most infectious when the symptoms are the most severe but could remain contagious for up to 21 days.
To prevent your sick child from spreading strep throat to others in your home, keep his or her eating utensils, dishes, and drinking glasses separate from those that everyone else is using.
  More results at FactBites »

 
 

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