Strep throat is a common respiratory illness that causes a sore throat, swollen neck glands and fever. In children, strep throat can cause headaches, abdominal pain with vomiting and occasionally a cough due to throat irritation. These kid symptoms are less common in adults.
Most sore throats in adults and children are caused by viruses and are self-limited. Viral sore throats DO NOT need antibiotic therapy. Strep throat, on the other hand is caused by a bacteria called Group A streptococcus. Strep throat can also be self-limited and often does not cause problems. So, why do we treat strep throat with antibiotics?
Strep bacteria can be easily identified by a rapid antigen detection test (RADT) that can be done in the office. This test will detect about 85-90% of strep cases. If the clinical symptoms are present and the RADT is negative, the swab should be sent to the lab for further testing with a genprobe testing that looks for the DNA of the strep bacteria. If this is negative, then the person does not have strep throat. If positive, the person is considered to have strep and should be treated. Genprobe testing usually will come back the next day from the lab depending on which lab is used.
There are two main complications of strep throat that can occur if the throat infection is not treated with antibiotics. There are at least 50+ strains of group A streptococcus bacteria. Two strains (M3 and M18) can cause a heart condition called rheumatic fever. Approximately 4 strains (M 1, 2, 4 and 12) can cause a kidney disease called post-streptococcal glomerulonephritis. So, only a small percentage of streptococcal strains that cause these illnesses. However, we cannot detect which strain is causing the respiratory sore throat with the RADT or genprobe testing. Only specialized research labs have these tests which are not available for office based testing. So, because we don't know which strain may be causing the current illnes, antibiotics are prescribed to treat the strep throat and prevent the possible complications of rheumatic fever and post-strep kidney disease. In addition, antibiotics will lessen the duration and severity of the strep throat illness allowing the patient to get back to their school and jobs faster.
Symptoms of Rheumatic Fever - Occurs about 3-4 weeks after the initial strep infection
Joint pain in one or more joints with redness and swelling of joints
Heart murmur caused by inflammation of heart valves
The involvement of the heart is the biggest concern and secondarily the joint inflammation
Symptoms of Post-Strep Kidney Disease - Occurs about 3-4 weeks after the initial strep infection
Decreased need to urinate
Protein spilling into urine
Swelling of hands, feet and face, especially around the eyes
High blood pressure
Any of the above symptoms noted after a recent strep illness should be evaluated by your doctor as there is the possibilty of long-term complications.
There is one final complication of untreated or even treated strep that is still being debated in the conventional medical community. That complication is called Pediatric Autoimmune Neuropsychiatric Syndrome (PANS). The major symptoms of PANS usually involve some neurological symptoms and more specifically mental health symptoms such as anxiety and obsessive-compulsive disorders. It is suspected that PANS is caused by an inflammatory reaction to the strep infection that persists beyond the illness. It can be short lived in duration but requires skilled history and diagnosis. For some susceptible individuals, PANS can be a prolonged illness. In the some conventional and most integrative medicine circles, PANS is a legitimate diagnosis that is taken seriously and is treated accordingly with a variety of protocols.
Treament of strep throat is with pencillin based antibiotics unless a patient is allergic to penicillin. Rarely, is group A streptococcus bacteria resistant to penicllin based antibiotics of which the most commonly used one is amoxicllin. In families and school, where strep can spread rapidly due to respiratory secretions, it is best to test all suspected individuals prior to treating with antibiotics. Patients are considered contagious until treated for 24 hours of antibiotic therapy and the full 7-10 days of treatment must be taken to ensure clearing of the bacteria. Again, most sore throats are caused by viruses and should not be treated with antibiotics. Testing for strep prevents the overuse of antibiotics leading to antibiotic resistant infections and also, prevents the gut disruption that can occur with antibiotics as they remove the good and bad bacteria from the body.
Spring 2018 is bringing lots of strep cases into the office so watch for that sore throat especially if there are other symptoms.
Nutrition & Yoga for Emotiona Health: Anxiety, Depression and ADHD
Saturday, May 12th at 10:30am at Whole Yoga & Wellness.
This interactive class for adults and kids will cover nutritional strategies and yoga for attention and mood problems such as ADHD, anxiety and depression. Yoga is a natural therapeutic practice that increases body awareness, decreases sensory overload, provides relaxation and improves physical well-being. There will be a presentation with yoga woven into the class so you won't be sitting the whole time! No yoga experience is necessary
*Children 8y and older may attend but need to be registered separately. Kids love yoga so this can be a great introduction to using yoga for calming and focus. Learn more and register at http://www.wholekidspediatrics.com/yoga-and-wellness
Led by integrative physician and yoga teacher, Dhanu Sant, you will learn nutritional and yoga for managing emotional health. You will leave with handouts with sample practice routines to implement at home.
Natural remedies for sore throats and other common illnesses can be overwhelming to know what to keep at home to heal your family. Download our awesome guide, The Wholistic Medicine Cabinet to learn how to keep a well stocked medicine cabinet. Just give us your email at http://www.wholekidspediatrics.com/yoga-and-wellness and you'll get the free downloadable e-book. Enjoy!