What is strep throat?
While many people use the terms sore throat, tonsillitis,
and strep
throat interchangeably, there are significant differences
between
these conditions. Understanding the differences can give
parents a
better idea of how and when to be concerned and seek advice
from the
child's doctor.
While strep throat is most common in children and
adolescents, it
affects people of all ages. This article focuses on causes,
symptoms,
diagnosis and treatment of strep throat in children and
adolescents.
Tonsils and tonsillitis
The tonsils are red, oval clumps of tissue located at the
back and to
the sides of the throat. This location allows the tonsils to
intercept
germs as they enter the child's body through the nose and
throat. They
contain infection-fighting cells and antibodies that stop
the spread
of the germs further into the body. When the tonsils become
red, sore,
and swollen, this inflammation is called tonsillitis. This
is not a
specific term, as there are many causes of tonsil
inflammation.
Sore throat caused by viruses
In infants and children, the most frequent cause of
tonsillitis is an
infecting germ called a virus. For a viral infection, no
antibiotic is
needed (unless the infection becomes complicated by a
subsequent
bacterial infection), and the infection can be expected to
run a
four-to-six day course. During this period, the child can be
treated
with lots of fluids, rest, and "feel better"
medicines that reduce
pain and/or fever, such as acetaminophen (Tylenol, Tempra,
Liquiprin,
etc.) or ibuprofen (Motrin, Advil, etc.).
Sore throat caused by bacteria
Bacterial causes of sore throat or tonsillitis can require
further
attention from parents and pediatricians. Streptococcus, or
strep, is
the most frequently found bacterial cause of sore throat.
This germ
requires an antibiotic for rapid treatment. Antibiotics do
not lower
the body's immune system or make it "lazy." On
the contrary,
antibiotics enable the normal, healthy immune system to kill
bacteria
(like strep) more rapidly and effectively.
What are the symptoms of strep throat?
When the child's throat infection is caused by strep, the
symptoms
vary quite a bit depending on the child's age.
Infants primarily experience a thick "colorful"
(yellow or green)
drainage from the nose and possibly a low-grade fever, with
fussiness,
irritability, and a decrease in appetite.
Children aged one to three ("toddlers") may
complain of a sore throat,
trouble swallowing, poor appetite (yes, even less appetite
than
normally seen at this age!), crankiness, and swollen glands
(lymph
nodes) beneath the jaws.
Older children generally look and feel awful with strep
throat! They
can have high fevers, very painful throats, often severe
difficulty
swallowing, and pus which can sometimes be seen covering the
tonsils.
These complaints mean that the child should see the doctor
right away,
as distinguishing viral and bacterial causes of tonsil
infection is
very important for correct treatment of the infection.
When should I be concerned about a possible strep throat?
Parents should be concerned about a sore throat that does
not improve
after a sip of water after arising from sleep, or one that
is
accompanied by a headache, high fever, stomach ache,
vomiting, or
severe tiredness. The presence of a red, somewhat
rough-to-the-touch
rash is also a concern, as strep infection along with a rash
is known
as scarlet fever (no more dangerous than strep throat
without a rash,
but this is a term that continues to strike fear into
parents'
hearts!). An urgent call to the doctor's office is
appropriate if the
child has extreme difficulty swallowing that causes
drooling, or is
having difficulty breathing.
How is strep throat detected by the doctor?
During the doctor's physical examination, a throat culture
might be
taken by touching a soft cotton swab to the throat and
tonsil area.
Germs from the swab are smeared onto a special plate and
sent to the
laboratory for evaluation of strep or other bacteria. After
twenty-four hours, the rapidly-growing strep germs can be
identified
if present in the culture. There are also rapid-strep tests
available
that can give results in minutes. And while the "feel
better"
medicines are O.K. to take before the culture or tests are
obtained,
taking any antibiotic prior to seeing the doctor should be
avoided.
Even a single dose of antibiotic can interfere with the
culture
results and your doctor's ability to correctly diagnose and
treat the
infection.
How is strep infection treated?
If a strep infection is detected, an antibiotic is
prescribed.
Antibiotics commonly used to treat strep throat infections
include,
among others, Penicillins [amoxicillin, (Amoxil, Dispermox,
Trimox) ,
Macrolides, such as erythromycins (E-Mycin, Eryc, Ery-Tab,
PCE,
Pediazole, Ilosone)], azithromycin (Zithromax), and
clarithromycin
(Biaxin), and Cephalosporins [cephalexin (Keflex, Keftabs,
Biocef )].
It is important to take the full course of antibiotics as
prescribed
and not to stop the medication when symptoms resolve.
Prematurely
discontinuing antibiotics can result in the infection being
inadequately treated with potentially adverse consequences.
Why is it very important to detect and treat a strep throat?
The condition known as rheumatic fever is a disease that
affects the
joints and heart and is caused by untreated or inadequately
treated
strep infection. Rheumatic fever can cause damage to the
heart valves.
Fortunately, it is now uncommon in the current antibiotic
era. Another
complication that can occur after inadequately treated strep
throat is
a kidney inflammation called glomerulonephritis. This can
cause
decreased kidney function, and blood and protein in the
urine.
How about having the tonsils taken out?
Surgical removal of the tonsils is much less common today
thanks to
the present ability to rapidly and accurately diagnose strep
infection, and thanks to the excellent antibiotics currently
available. But occasionally, your doctor might suggest the
possibility
of the need for surgical removal of the tonsils
(tonsillectomy) if you
child:
1. is experiencing frequent episodes of tonsillitis
(especially
those caused by the strep bacteria),
2. has tonsils that are so large, even when your child is
well,
that they cause, not just "snoring" but
significant obstruction or
blockage of the airway during sleep (called "sleep
apnea"), or
3. develops an uncommon but serious deep-seated infection
within
and surrounding one or both of the tonsils, called a
"peritonsillar
abscess".
Strep Throat At A Glance
* Most other throat infections are caused by viruses.
* The symptoms of strep throat include fever, sore
throat, and
swollen lymph glands in the neck.
* The diagnosis of strep throat is confirmed by a throat
culture
or rapid-strep tests.
* Strep throat is best treated with antibiotics.
Source: h
ttp://www.medicinenet.com/strep_throat/article.htm
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