One important cause of sore throat
in the outpatient setting is streptococcal pharyngitis, or strep throat. Streptococcal pharyngitis is an infection caused by a bacterial pathogen named streptococcus pyogenes, also known as group A streptococcus.
It is important to note that most cases of sore throat, even cases of sore throat and fever, are caused by viral infections. There are tests available to confirm the presence of a streptococcal throat infection, including a rapid strep test and the more accurate throat culture. Strep throat is usually a self-limited infection lasting 2 to 5 days in untreated patients. However, treatment with antibiotics has long been recommended to prevent the possible complications of streptococcal pharyngitis, including tonsillar abscess, scarlet fever, rheumatic fever, toxic shock syndrome, and even meningitis. Scarlett fever is a complication of streptococcal pharyngitis wherein patients experience a prolonged fever and a diffuse red rash. This rash consists of multiple small (about 1/4 to 1/8 of an inch) raised red spots, which give a sandpaper texture to the skin.
The rash usually starts on the head and neck and extends to cover the trunk and finally the extremities, excluding the palms and soles. In the last stage, the skin affected by the rash sheds. Other symptoms of scarlet fever include a beefy red discoloration of the tongue, giving it the appearance of a strawberry and prompting the term "strawberry tongue". Scarlet fever is actually caused not by the strep bacteria itself, but by an immune response to bacterial toxins in previously sensitized individuals. Streptococcal pharyngitis and its complications are most often treated with a course of oral antibiotics, a common choice being antibiotics of the penicillin class like augmentin or amoxicillin. Usually antibiotics are given for about 10 days. After 24 hours patients are no longer considered contagious and symptoms usually improve within the first 3 to 5 days of treatment. In cases of scarlet fever, although most symptoms can get better in the first few days of antibiotic treatment, the rash can linger for as long as 2 to 3 weeks.
If you or someone you know has scarlet fever or any of its symptoms, you should make an appointment to be seen by a primary care physician
as soon as possible so you can be fully evaluated, prescribed the appropriate treatment, and hopefully avoid the complications sometimes associated with untreated streptococcal pharyngitis.