Strep throat (bacterial tonsillitis): Symptoms, diagnosis and treatment

What is strep throat?

If you're feeling fine one moment, and then suddenly your throat is extremely painful, you've got a temperature, and all your energy has vanished in a haze of illness, you probably have strep throat, also called bacterial tonsillitis.

Strep, in this case, stands for Streptococcus pyogenes, a common strain of bacteria that can live in your throat and nose for months without causing any harm. Tests show that about 15 per cent of healthy people have the strep “bug” living quietly in their mouths or throats, without causing any symptoms. Often people who are carriers for strep have no symptoms, but they can pass an infection on to others.

Once in a while, though, these bugs can turn on you. Maybe you've been under too much stress, or your immune system has been overtaxed from fighting a virus such as a common cold or the flu. Or perhaps you've picked up a bug from an infected person. Whatever the reason, the normally quiet strep organisms can suddenly start spewing out toxins and inflammatory substances to bring on a sore throat and other symptoms.

Although strep throat feels awful, it can be cured easily these days with antibiotics such as penicillin or erythromycin. In fact, one of the biggest problems with strep is getting people to seek treatment. Because a temperature and sore throat are also symptoms of colds and the flu, strep throat is often mistaken for these ailments.

Colds normally take several days to develop, they are caused by viruses and are usually accompanied by a cough, stuffy or runny nose and sneezing, and they go away on their own. A strep throat, by contrast, usually arrives in a hurry and without any other cold or flu symptoms and should be treated with antibiotics to stop its spread to others.

Strep throat should never be taken lightly. Untreated, strep throat can quickly lead to a more severe illness such as rheumatic fever or acute nephritis (which can damage your kidneys), both of which can be fatal.

What are the symptoms of strep throat?

• Sore throat that comes on rapidly.
• Difficulty swallowing.
• Headaches.
• Fever.
• A raw, red appearance to the back of the throat.
• White pus on tonsils.
• Tender, enlarged lymph nodes in neck.
• Rash.
• Absence of a cough, stuffy nose or other upper-respiratory symptoms.

Although, by definition, strep throat is caused by the Streptococcus pyogenes bacteria, other bacteria can occasionally invade the throat and cause similar symptoms. Other possible bacterial invaders include staphylococcus, neisseria and Haemophilus influenzae.

Stress, overwork, exhaustion and fighting off viral infections can weaken the body's defences and allow strep throat to attack. And like other throat infections, strep throat also tends to occur during the colder months.

People usually develop strep throat when their immune systems are not functioning at their peak. Because strep is contagious, treatment is critical since these bacteria can be spread to others by coughing or sneezing.