Streptococcal Infections

What are streptococcal infections?

Strep is short for Streptococcus, a type of bacteria that often lives in your nose and throat. Most strep infections are mild, but some may become serious depending on your overall health.

There are several types of strep. Two of them cause most of the strep infections in people: group A and group B.

How do streptococcal infections spread?

There are different ways that streptococcal infections may spread:

• Group A strep can be spread from a person who has the infection, even if they don't feel sick, when:
  • They cough or sneeze
  • You share a glass or utensil with them
  • You touch something with the bacteria on it and then touch your eyes, mouth, or nose
  • You touch their open wound or sore
• Group B strep can be passed to a newborn through fluids during a vaginal birth

Who is more likely to get a streptococcal infection?

• Group A strep infections are most common in children ages 5 to 15, but adults can get them too. You may be at higher risk if you have a weakened immune system, open sores or wounds, or certain viral infections such as a cold or flu.
• Group B strep is most often a concern for newborns. Adults can also get group B strep infections, especially those 65 or older or who already have other health problems.

What are the symptoms of streptococcal infections?

Symptoms depend on the type of infection. Most group A strep infections are mild, but some can be serious.

Group A strep may cause:

• Strep throat. A sore, red throat. Your tonsils may be swollen and have white spots on them.
• Scarlet fever. An illness that follows strep throat. It causes a red rash that spreads across the body.
• Impetigo. A skin infection that causes sores or blisters, often around the mouth, nose, or on the arms and legs.
• Cellulitis. A skin infection that causes redness, swelling, and pain, usually on the legs.
• Necrotizing fasciitis (flesh-eating disease). A rare but serious infection that spreads quickly through the skin and tissue.
• Streptococcal toxic shock syndrome. A rare but life-threatening illness where the bacteria release toxins that can cause organ failure.

Group B strep may cause:

• Blood infections, pneumonia and meningitis in newborns
• Urinary tract infections, blood infections, skin infections, and pneumonia in adults

How are streptococcal infections diagnosed?

Group A strep. How strep is diagnosed depends on the type of infection. Your healthcare provider will usually diagnose strep throat with a rapid test or a throat culture. Other strep infections may require a physical exam, lab tests, imaging, or in some cases, surgery.

Group B strep. If you are pregnant, your provider will typically screen you for group B strep around 36 to 37 weeks.

What are the treatments for streptococcal infections?

Your treatment will depend on the type of infection:

• Group A strep infections often go away on their own after about a week. If you need treatment, your provider will likely prescribe antibiotics. More serious (invasive) group A strep infections may require you to receive antibiotics in a hospital. Without treatment, these infections can lead to serious health problems.
• Group B strep infections in pregnant women are treated with intravenous (IV) antibiotics during labor to protect the newborn. Adults with group B strep infections are also treated with antibiotics.

Can streptococcal infections be prevented?

You can help prevent some group A strep infections by practicing good hygiene habits, including:

• Avoiding close contact with someone who has an infection
• Washing your hands often with soap and water
• Covering your mouth and nose when you cough or sneeze

To help prevent group B strep infections in newborns, you should get screened during pregnancy. If you test positive, antibiotics given during labor can protect your baby.

Questions for your care team

General prompts to help prepare for your appointment.

• How does this information apply to my situation?
• Which symptoms or results need evaluation?
• Which tests are useful, and what can they tell us?
• What care options, benefits, and risks should we discuss?
• When should I seek urgent help, and whom should I call?
• When is follow-up, and how will we know whether the plan is working?