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Doctor's Diagnosis: Strep throat

“Strep throat” means specific bacteria known as Streptococcus

“Strep throat” means specific bacteria known as Streptococcus are causing the sore throat. There is usually a rapid onset of severe throat pain, high fever and swollen lymph nodes in the neck. On examination, the tonsils appear red and swollen. Credit: iStock

As school gets going into high gear, pediatricians will once again encounter many children complaining of sore throats, often accompanied by adults who are worried the child may have strep throat. Few of the adults realize that the main goal of diagnosing and treating strep throat is to prevent heart disease. Let me explain.

“Strep throat” means specific bacteria known as Streptococcus are causing the sore throat. There is usually a rapid onset of severe throat pain, high fever and swollen lymph nodes in the neck. On examination, the tonsils appear red and swollen.

The problem is that viruses cause most sore throats, and even experienced clinicians cannot reliably determine if it is strep just by examining the patient. Traditionally a throat culture is done to determine if strep is causing the problem. Although accurate, the result is not available for a day or two.

Other tests can now be done right in the office while the patient waits. However, these rapid tests are known to miss many cases of strep. Just to be safe, many pediatricians will do both a rapid test and a culture.

Treating strep throat is usually straightforward with currently available antibiotics. After beginning treatment, most patients will feel better in a day or two and can then return to school or work.

The most important reason to treat the strep throat, however, is that if left untreated the body’s reaction to the infection can lead to the development of rheumatic fever. This disease involves a variety of problems such as skin rash and nodules, arthritis, and heart disease that often involves the heart valves. The heart damage is often permanent and may eventually lead to heart failure requiring surgical repair or replacement of the valves. Though it has become less of a problem in the United States, rheumatic fever remains a major cause of heart disease in many parts of the world.

Treatment also helps prevent strep from spreading and causing infections of the ears or sinuses. Additionally, it helps limit the transmission of this highly contagious disease.

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Unfortunately not all complications are readily preventable. For example, it is not unusual to develop inflammation of the kidneys after a strep throat infection even if it was treated appropriately.


Dr. Stephen Picca of Massapequa is Board Certified in both Internal Medicine and Anesthesiology. He is retired from practice. Questions and comments can be sent to Dr. Picca at health@newsday.com.

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