Complaints & connections · borters.ch
Here the test pays off: only the bacterial sore throat benefits from antibiotics.
Also known as: streptococcus · GAS/GBS · scarlet fever · strep throat
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
A bacterial group with varied presentations: Group A strep causes sore throat, scarlet fever and skin infections; rarely immune-mediated sequelae follow (rheumatic fever, glomerulonephritis). Diagnosis by throat swab; the ASO titre shows past infection. Treatment: antibiotics, usually penicillin.
Coating on the tonsils occurs with viruses too. The throat swab takes minutes and prevents unnecessary antibiotics — and finds the cases where one makes sense.
After two days one is usually free of complaints — the treatment nonetheless carries on, because it is about the rare late effects on heart and kidneys. One is no longer catching about twenty-four hours after starting.
One to three weeks later an inflammation of the kidneys can follow: dark, cola-coloured urine, swollen eyelids in the morning, high blood pressure. Rare, but the reason this infection is taken seriously.
A sandpaper rash, a raspberry-red tongue, pallor around the mouth — that is the same germ with a toxin added. Treatment is the same; staying away from nursery applies only while there is no treatment.
Scratched mite burrows become infected with bacteria. If only the impetigo is treated it comes back as long as the mite stays — especially in children.
After walking barefoot in the tropics a flea burrows under the skin, usually at the nail edge. Removed carelessly, the spot becomes bacterially infected.
Group A strep with typical rash and “strawberry tongue” — well treated with antibiotics.
Rare immune-mediated sequela affecting heart and joints — early antibiotics prevent it.
Rare kidney inflammation after infection — usually self-limiting.
Penicillin still works reliably here; resistance to penicillin has not appeared in this organism. It shortens the sore throat by about a day — the real reason for the ten days is a different one: avoiding rheumatic fever, which can arise two to four weeks after the infection. A person is no longer infectious after twenty-four hours of treatment. Without an antibiotic the throat heals anyway in three to seven days.
About ten to fifteen in a hundred sore throats in adults and twenty to thirty in children come from streptococci. The rapid test gives a result in five minutes. A person is no longer infectious after twenty-four hours of treatment; untreated, two to three weeks. Rheumatic fever appears two to four weeks after the infection and has become rare in our part of the world — it is the reason for the ten days of penicillin.
A rapid start, strong pain on swallowing, fever, coated tonsils, swollen neck nodes — and strikingly: no runny nose, no cough, no hoarseness.
In scarlet fever a finely spotted, rough rash starting on the trunk, with a raspberry-red tongue and pallor around the mouth. Later the skin peels on hands and feet.
In younger children belly pain, nausea and headache are often in the foreground while the sore throat is hardly mentioned. So a look into the throat belongs with it.
Two to four weeks later: dark or foaming urine, swollen eyelids, or wandering joint pain with fever. Those are the sequels for which this throat infection is treated.
A single dose of cortisone shortens a severe sore throat by some hours — that has been studied. It does not replace the antibiotic where one is needed, and it is not a standard.
After a viral infection a painful thyroid inflammation occasionally appears — with throat pain that pulls forward and towards the ear. It is regularly mistaken for tonsillitis; the blood count and the examination tell them apart.
Honey eases sore throat — that is well studied. It does not act against streptococci; with a proven infection the point is avoiding late complications, and that needs the antibiotic.
Sage as a gargle eases sore throat in small studies about as well as lozenges. It is relief, not treatment of the infection.