Strep Not so Benign

Strep: (Not So Benign cause of Sore Throat.)

In the United States, a visit to a doctors office with complaints of fever and a sore throat, will always generate a rapid strep test, or a throat culture. Strep untreated has some dead give away signs. Very high fever 102.5 – to as high as 104 F, with usually an absence of sniffles or cough. The fever invariably spikes at night. Swallowing feels like a cherry bomb going off in your throat. Kids who get the bug usually pick it up from other kids who have the infection, from sharing drinking cups. Strep is highly contagious.

These signs alone are usually provoke the well trained doc or nurse practitioner to look at the tonsils. The tonsils will be enlarged or beet red, with or without purulence (pus.) Strep love to live on the tonsils. On the tonsils there's plenty of food, moisture and warmth, for the strep to take up residence, and live out their microscopic lives. The disease can occur without tonsils if they have been removed (but strep prefer tonsils.). In that case the back of the throat will be red, angry looking, with redness on the uvula ( that thing that dangles in the back of the throat.) The cause of Strep throat is the bacteria Streptococcus Pyogenes or beta hemolytic Strep.

A throat culture or rapid strep should always be done and the infection should always be treated if the bug is identified. And the reason for that is: Strep is potentially very dangerous.The bug can leave the tonsils, get into the blood stream and take up residence in the kidneys, or in the heart valves causing rheumatic fever or kidney disease (post streptococcal glomerular nephritis. -a degenerative disease..) There is also the possibility the disease can become systemic in susceptible and compromised people. It can cause septic shock and death -.In the elderly and small children and in those with inflammation variabilitiees, or immune problems.

It can lead to dehydration and electrolyte imbalance. In people for whom the disease might otherwise an uncomfortable passing sickness,.treatment is the standard, because of the risk they pose to others, who may not be able to tolerate the illness.

Even though some people can contract the disease, have it resolve without incident, others are devastated by it. The rule is, identify the strep and treat it. This is why throat culture or rapid strep is standard in the US. And why tonsilectomy is offered for multiple episode occuring in one year.

In fact, in the US, 7 infections of strep in one year, mandates Tonsillectomy. As, apparently, some kids become carriers and break out with the disease too frequently. Usually after a viral infection. The reason is: the viral infection causes fever that kills off the normal bacteria on the tonsils, and the tonsils swell releasing streptococcus that hides in the pockets of the tonsils. The expanded "land mass," (surface area) with no other competition from normal bugs, is like a gold rush to Strep. They branch out, conquer new territory on the tonsils, establishing their strep empire on a microscopic level - rivaling early Roman Imperialism. They raise their strep progeny in a kind of Strepish Babylon on the tonsils. When the tonsils are removed, the infections go away, and the associated risks disappear.

Too often I've heard people complain that they were told their child had a virus. But, viruses don't hang on forever. And they don't produce raging fevers, and usually don't cause severe sore throat. A virus will go away in most cases, but when symptoms hang on, and the child is becoming prostrate with fever every nignt, miserable, and anorexic, it's time to insist that clinical guess work be replaced with science. Rule out Strep. by throat culture, or rapid strep. Be prepared too, that if the culture comes back negative, that it's possible some neophyte lab tech screwed it up, - it might have it repeated.

I had a friend whose child was sick with these symptoms in Brittan. I said, "check her throat": -.beet red, complains of swallowing difficulty - wont eat, fevers every night for week and one half. I said: " take her to the ER." She did. They said the child had a virus. I said, "no – it isn't viral, they can't say that, they have to back it up."

I was concerned tor two reasons, one: this kid was not getting better, and the woman was compromised - I was worried about cross infection. I asked her to go back, and ask for a throat culture. They said “oh we don't do that. It's viral.” She came back and I was incredulous. I asked her to go back, and explain her risk and by this time, she was infected. She got the party line “Oh we don't treat that because of resistance. Besides it's probably viral...”

I told her to go private ( she had socialized medicine- which is crushed in Britain and failing, they were thinking about cost, not resistance.) . And she did, she got penicillin. The child who was listless, perked up in 24 hrs on penicillin. A symptomatic and bursting with energy, eating and hydrating, and the woman was treated as well (a n ote here: the symptoms are markedly reduced within 24hrs...strep hate pennicillin - but, there's a tendency to stop the med too early if the child resists because of feeling better, but this is really where the threat of resistence, and return of the infection can reoccur - finish the 7-10 day course of antibiotic.)

Now here's the clincher: a woman went into that same ER complaining of the same symptoms.

They sent her home saying it was viral without checking. She died within a few days from septic shock, it was strep infection. Because the British have allowed so many undocumented workers, and illegals into the country, and because they have allowed massive welfare fraud, the social system of medicine has failed due to cost. They were doing a financial calculation: if we just send them home, 90 percent will get better anyway. And, I suppose if we allow socialized medicine here, eventually we will get the same type of cost based rationing of care. But, knowledge will forestall complications, and cash reserves to go private will provide a safety net Patients need to know how to advocate for themselves. Now, with the rise of H1N1, there may be more assumptions about the cause of symptoms, as being “viral” when only lab tests can confirm this one way or the other. No lab work was done in any of the cases I mentioned. Be armed with education, and advocate for yourself and your children.Again, you may print this article and show it to those who argue with commons sense, and good medical practice.

Update:

Just recently, a little girl in Britain  died, because the hospital did  not test for GROUP A STREP. It appears that British hospitals need to rule out all causes for high fever, and sore throat. Especially the most obvious cause, group A strep.  All of the antivirals in the world would not have helped this child, because it is institutional policy to pretend strep infections don't exist and call all of these symptoms viral...the big danger in Britan and eventually here, if we get rationed health care, Is that people will be diagnosed with swine flu, when they dont have it, or if they do, and also have strep, their survival chances are diminished because the strep is not being treated and killed..

http://www.timesonline.co.uk/tol/life_and_style/health/article6722616.ece