Sore (Strep) Throat: Online Diagnosis and Treatment

Sore throat, technically called pharyngitis, can be irritating or downright painful and can add to the challenges of daily life. Most people have heard of strep throat and how, if left untreated, it can lead to serious complications. So how would you know whether a virus, streptococci bacteria, or something else is more likely causing your sore throat?

Scheduling a consultation with a virtual doctor on the Telegra MD telehealth platform is simple and convenient. You will receive a diagnosis, a treatment protocol, and an appropriate online prescription to treat your sore throat. Telehealth for sore throat treatment makes it easy to consult with a virtual doctor and receive an antibiotic to treat strep throat quickly and easily, even if you don’t have insurance.

Your throat can become inflamed and sore from post-nasal drip, allergies, dryness after drinking alcohol or being in a polluted environment, acid reflux disease, or secondary to a viral or bacterial infection. Many of these conditions are diagnosed based on your medical history and symptoms. Although antibiotics are useful only for treating bacterial infections, your virtual doctor may recommend allergy treatment or antiviral, pain, or anti-reflux medications to treat the underlying cause of your sore throat.

Telehealth for sore throat treatment is the perfect option when you need an answer fast. You can schedule an online appointment with a virtual doctor using the Telegra MD platform and receive a diagnosis. Your virtual doctor can give you tips on relieving your pain, discuss the most likely cause of your symptoms, and call in a prescription to a local pharmacy. Online doctors who treat strep throat provide 24-hour appointment access, which means you can expect doctor access whenever you need it, leading to an earlier diagnosis and treatment.

What Is strep throat?

Acute pharyngitis is a common condition accounting for an estimated 15 million doctor visits annually in the United States.¹ Viruses account for about 70-80% of all infectious sore throat doctor visits. Streptococcus pyogenes, also known as group A strep, accounts for about 5%-15% of all sore throat visits in adults and 20%-30% in children. The peak incidence of strep throat is in the winter and spring.²

Strep throat is a bacterial infection that, when untreated or inadequately treated, can lead to serious complications such as pockets of infection in and around the tonsils, ear infections, sinus infections, and other infections of the head and neck. Other complications associated with strep throat include rheumatic fever, scarlet fever, and post-streptococcal glomerulonephritis.

• Acute rheumatic fever (ARF): symptoms of ARF may appear 2-3 weeks after strep throat. The exact disease process is unknown, but it occurs in 2%-3% of people with untreated or inadequately treated strep throat. Symptoms include heart inflammation, joint pain, skin nodules and rash, and chorea, a type of movement disorder.
• Scarlet fever: a fine, sandpapery rash may occur with strep throat. When both are present, the condition is called scarlet fever. The classic rash is followed by peeling within a week.
• Poststreptococcal glomerulonephritis (PSGN): PSGN is an immunologically mediated disease that occurs between 10 days and three weeks after strep throat. Antigens on strep bacteria that trigger the immune system are also found in the filtering units of the kidney. The immune system targets the kidney in the same way it targets strep bacteria for destruction. PSGN symptoms include high blood pressure, swelling, lethargy, weakness, and decreased appetite.

Can strep throat Be Treated Through Telehealth?

Telemedicine for strep throat treatment makes it easy to arrange a medical consultation with a virtual doctor to discuss your sore throat and receive a prescription for an antibiotic if the diagnosis is strep throat. Assuming your Telegra MD virtual doctor agrees that your symptoms are consistent with strep throat, they will send your online prescription to your local pharmacy electronically so you can get started on treatment as soon as possible.

How Do You Get strep throat?

Strep sore throat is most commonly spread by direct person-to-person contact. If you come in contact with respiratory droplets, saliva, wound discharge, or nasal secretions from an infected person, you may also become infected.

People who live and work in crowded conditions, such as schools, daycares, or military settings, are more likely to become infected. According to the Centers for Disease Control and Prevention, Group A strep can also be spread via food and drink, although this is rare.

The incubation period for Group A strep sore throat is 2 to 5 days. If you have been around someone who has symptoms consistent with strep throat in the past few days, you may also be infected.

What Are the Common Symptoms of Strep Throat?

Common symptoms and signs associated with strep throat include:²

• Fever
• Pain with swallowing
• Sudden onset of symptoms
• Swollen glands
• Redness of the throat and tonsils
• White patches on the tonsils
• Petechiae, small red dots on the roof of the mouth
• Scarlatiniform rash: sandpapery rash
• Strawberry tongue; swollen bumps on the surface of the tongue
• Stomach pain
• Headache
• Fatigue

Symptoms that are more consistent with a viral cause of sore throat include the following:

• Cough
• Runny nose
• Hoarseness
• Ulcers or sores in the mouth
• Conjunctivitis
• Diarrhea
• Low-grade temp or no fever

Children with upper respiratory symptoms such as a cough, runny nose, hoarseness and mouth ulcers are more likely to have a viral cause for their sore throat than children who do not have these symptoms. However, clinical features alone will not distinguish between a sore throat caused by strep bacteria and a virus.

Young children and infants may have a low-grade fever, decreased appetite, and a thick nasal discharge as classic symptoms of a strep infection.

When Should You See a Doctor for Strep Throat?

See a doctor if you suspect you have strep throat or are unsure of the cause of your sore throat. While strep throat will go away on its own, not treating a symptomatic strep infection increases the risk that you will transmit the infection to other people and increases the risk of developing serious complications such as post-strep glomerulonephritis and rheumatic fever.

Serious signs and symptoms associated with a sore throat include the following:

• Drooling
• Asymmetric tonsils
• Inability to fully open your mouth
• Facial swelling on one side
• Muffled voice
• Fever with extreme fatigue

Are Some People at Increased Risk of Strep Throat?

Age (5 to 15 years old) and crowded living and working conditions are the biggest risk factors for strep throat.

How Do You Diagnose Strep Throat?

Strep throat is diagnosed using a rapid strep test or a throat culture. When performed correctly, throat cultures are very sensitive for identifying Group A strep infections. Rapid strep tests are less sensitive and specific for group A strep. If a rapid strep test is positive and the person has group A strep symptoms, they are treated with antibiotics. If they have a negative rapid strep test but symptoms of strep throat, a throat culture is done to confirm the results.

According to the Centers for Disease Control and Prevention, testing for Group A strep is not routinely indicated in children under age three and adults because their risk for acute rheumatic fever is extremely low, especially in adults with symptoms consistent with a viral infection.

How do You Treat Strep Throat?

If your doctor diagnoses strep throat, they will prescribe a course of antibiotics. Treatment for group A strep sore throat shortens the duration of symptoms, prevents complications such as rheumatic fever, and reduces the likelihood of transmitting the infection to other people.

Recommended antibiotics for treating group A strep sore throat include:

• Penicillin
• Amoxicillin
• Cephalexin
• Cefadroxil
• Clindamycin
• Azithromycin
• Clarithromycin

If you are prescribed a course of antibiotics, take the full course of medication even though you will probably feel much better within 1 to 2 days.

Some people carry group A strep bacteria in their mouths and tonsils. During the winter and spring, up to 20% of school-aged children may be asymptomatic strep carriers.³ Asymptomatic Group A strep carriers do not require treatment. They are unlikely to transmit the infection to others or to develop group A strep-associated complications.

If you have a sore throat caused by a viral infection or allergies, try these steps to relieve sore throat pain:

• Take acetaminophen or ibuprofen
• Gargle with warm salt water
• Suck on lozenges or hard candy
• Try a mixture of lemon juice and honey
• Suck on popsicles
• Use a humidifier
• Throat sprays

Can You Prevent Strep Throat?

People who have been diagnosed with a Group A strep throat infection should remain in isolation until their fever is gone and they have been on antibiotics for at least 12 to 24 hours. This will reduce the spread of group A strep and protect people who have not been infected.

The steps for diagnosing strep throat after seeing a doctor online through telemedicine are similar to seeing your local doctor. In both cases, you would:

• Make an appointment: Typically, appointments to see virtual doctors through telehealth are much easier to make and are more convenient, as many telemedicine companies provide online telehealth services for strep throat treatment at any time, day or night.
• Provide a medical history: Whether completing forms in your local doctor’s office or online before consulting with your virtual doctor, you will need to provide a medical history.
• Consult with your doctor: After reviewing your medical history forms, your virtual doctor will determine whether your symptoms are consistent with strep throat.
• Treatment: If you are diagnosed with strep throat, your virtual doctor will transmit a prescription for strep throat treatment to your local pharmacy.

Frequently Asked Questions

Disclaimer

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

References

1. Ebell MH,  Smith MA,  Barry HC,  Ives K,  Carey M. The rational clinical examination. Does this patient have strep throat?, JAMA, 2000, vol. 284 (pg. 2912-8)

2. Maltezou HC, Tsagris V, Antoniadou A, Galani L, Douros C, Katsarolis I, Maragos A, Raftopoulos V, Biskini P, Kanellakopoulou K, Fretzayas A, Papadimitriou T, Nicolaidou P, Giamarellou H. Evaluation of a rapid antigen detection test in the diagnosis of streptococcal pharyngitis in children and its impact on antibiotic prescription. J Antimicrob Chemother. 2008 Dec;62(6):1407-12. doi: 10.1093/jac/dkn376. Epub 2008 Sep 11. PMID: 18786938.

3. Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, et al. Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America, Clinical Infectious Diseases, Volume 55, Issue 10, 15 November 2012, Pages e86–e102, https://doi.org/10.1093/cid/cis629