Uncovering the Truth About Sore Throat: Separating Fact from Fiction

Do We Need to Test Every Person with Sore Throat for Strep?

No, testing for strep is not necessary in most cases. Criteria like age, symptoms, and risk factors can help categorize patients with sore throat and determine the likelihood of streptococcal pharyngitis. Generally, younger children and adolescents have a higher risk of streptococcal pharyngitis, but most sore throats in this group and in adults are still caused by viruses.

Strep: Separating Fact from Fiction

Most people worry that if they have strep and don’t get the antibiotic to kill the bacteria, something bad will happen. However, most people with proven strep will recover normally even without antibiotics. It’s a common misconception that streptococcal pharyngitis must be treated with antibiotics or bad consequences will result, but it’s still important to make the diagnosis and treat it with antibiotics if found to be the cause of sore throat.

Serious Conditions that Present as Sore Throat

There are conditions that present as a sore throat but can be serious, such as Epiglottitis, Retropharyngeal abscess, Peritonsillar abscess, Mono (mononucleosis), and Covid-19. Symptoms such as breathing difficulties, severe pain when swallowing, neck pain, and difficulty swallowing, among others, can indicate a serious underlying condition. It is important to seek medical attention for proper diagnosis and treatment.

Viral Pharyngitis vs Strep

There are four signs and symptoms known as The Centor Criteria used to diagnose strep throat in adults. They are: tonsillar exudates (pus on the tonsils), swollen and tender neck glands, absence of cough, and fever or history of fever. These criteria are used in primary care to determine if a person with sore throat needs a strep test. A rapid strep test is done if the Centor criteria are positive, and if it’s positive, treatment with antibiotics is usually prescribed.

Rapid Strep and Throat Culture

If a patient meets the Centor criteria, a rapid strep test is done. This involves taking a swab of the throat and tonsils, and results are usually available within 15-20 minutes. If the test is positive, the patient likely has strep and is treated with antibiotics. However, a negative result is not always definitive, so the provider may conduct a throat culture to confirm the results. This depends on the patient’s risk factors and Centor score. The culture results take 2-3 days.

The Significance of White Exudate on Tonsils

Many patients come to our emergency department concerned about white spots on their tonsils. A little white spot on the tonsils is not considered exudate, but rather a small white material that can collect in the tonsil crypts. Exudate, however, refers to the white, creamy substance covering the tonsils, which may or may not be related to strep throat.

Why Do We Treat Strep Throat?

One of the most common reasons for treating strep throat with antibiotics is to prevent the spread of infection to others. Strep throat is highly contagious, and the bacteria can be spread through coughing, sneezing, or even just talking. By treating strep with antibiotics, you reduce the amount of bacteria in your body, making it less likely that you’ll spread the infection to others.

Another reason we treat strep with antibiotics is to reduce the risk of complications. While most people will recover from strep throat on their own, some may develop serious complications, such as rheumatic fever or kidney inflammation. Antibiotics can reduce the risk of these complications and help prevent the spread of infection to others.

Over-Treating Sore Throat: The Dangers

While treating strep throat with antibiotics is important, over-treating with antibiotics is also a problem. Overuse of antibiotics can lead to antibiotic resistance, which makes it harder to treat infections in the future. In addition, antibiotics can have side effects, such as nausea, diarrhea, and life threatening allergic reactions.

The myth of misdiagnosing strep throat also contributes to over-treating sore throat. Many people believe that missing the diagnosis of strep throat is dangerous, but this is not the case. In most cases, the symptoms of strep throat will go away on their own even without antibiotics. However, it’s still important to seek medical attention if you suspect you have strep throat or if you have other symptoms that indicate a more serious underlying condition.

In conclusion, sore throat is a common condition that most people will experience at some point in their lives. It’s important to differentiate between viral and bacterial causes, as this will determine the best course of treatment. While strep throat is a serious condition that should be treated with antibiotics, over-treating with antibiotics is also a problem. The Centor Criteria can help determine if a person with sore throat needs a strep test or antibiotics, and a rapid strep test or throat culture can confirm the diagnosis. If you’re experiencing symptoms of sore throat, seek medical attention to determine the best course of treatment.

While sore throat can occur at any time, strengthening your immune will allow you to have more resiliency to both viral  and bacterial throat infections. Herbal remedies such se these three top immune boosters can be a great addition to overall holistic boost for your immune system. To learn more about complementary therapies, visit National Center for Complementary and Integrative Health