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Streptococcal pharyngitis - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Ear, Nose and Throat Problems
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3391 Questions
User :   i am very worried about my 10 yr. old grandson who has had stept throat 3 times in 6 wks. he has just gotten over it 2 wks ago and now he has it again...another round of antibiotics. the cultures were positive each time, and he runs 100-101 fever each time for a day or two. he takes the antibiotic and the next day he is feeling fine. my daughter sends him back to school (which i wouldn't do...i think he needs quiet and rest for a few days) but it really worries me that he might get kidney or heart damage, and when does this end? my husband didn't take care of his strept throat and he got nephritis later. this would not be a staph infection would it? of course the dr. didn't mention that. she did a cbc on him and that was fine she said, except for the infection. please help...i just want to get him well! and i don't think he needs to go back to playing on his baseball team in the heat (it's hot here...75-85 degrees) until late at night (10pm) then go to school the next day.....i'm sorry, but i'm very worried about him! thank yo
Doctor :   Hi
Doctor :   please give me a couple of mins to read your query.
Doctor :   may I ask you a few relevant questions?
User :   sure
Doctor :   when did the child start with problems of sore throat?
User :   about 6 wks ago
Doctor :   ok , this was the first time?
User :   yes, other than viral sore throats through the years when younger
Doctor :   does he have any symptoms right now?
Doctor :   symptoms of sore throat , fever not coming down , abdominal pain , skin lesions , etc?
User :   he just went to the dr. on fri. and she gave him a culture which was positive and more antibiotics....fever comes down no stomach pain or lesions...
Doctor :   ok
Doctor :   was he examined for tonsills?
User :   yes, and the doctor said his tonsils were not enlarged..they were red but she said something like "thin looking" i think my daughter said??
Doctor :   ok
Doctor :   let me explain it to you
Doctor :   streptococcal sore throat is common in children
Doctor :   especially at age between 10 to 15 yrs
Doctor :   the child presents with sore throat, headache , fever, abdominal pain and rashes also many times
Doctor :   sometimes it may get complicated by an associated viral infection too
Doctor :   tonsils will generally be inflamed and this will be an associated finding
Doctor :   since this is the first time he has picked it up
Doctor :   there is nothing to worry
Doctor :   the treatment wil always mean an antibiotic course
Doctor :   and if the fever and other symptoms resolve we say that the child is fine
Doctor :   what is very important here is , the course of antibiotics
Doctor :   one must make sure that the child has taken the full course and not stopped treatment in between
User :   but he has had strept throat 3 TIMES IN 6 WEEKS!! THIS IS HIS 3RD ROUND OF ANTIBIOTICS, and his mother always makes sure he takes them all for the full 10 days.
Doctor :   ok , I understand
Doctor :   some times the infections take time to resolve
Doctor :   as long as the child is doing fine with no symptoms like very high fever, severe rashes in his body , abdominal pain and dehydration ,etc, we do not have to worry
Doctor :   As you mentioned about going to school , I would advise that the child avoids going to school, as I fel he has picked it up from one of his friends at school or play
User :   i agree with you strept something that can spread throughout the body like staph? I'm very ignorant about it.....
Doctor :   yes , streptococal infections are contagious
Doctor :   they are passed on through close contact and hence very common in children of school going age
Doctor :   this explains as to why he has got such frequent episodes
Doctor :   i suggest , he takes enough rest and picks up good immunity and resistance again and then goes back to school
User :   ok i HOPE that this time the treatment will cure him completely. the dr. said he needed a stronger antibiotic this time, so that is what she gave, but i do not know the name. thank you for your help.
Doctor :   yes , we put them on higher doses or change the antibiotic if the response has not ben good
Doctor :   i suggest he follow warm saline gargles whenever he feels a discomfort in throat
Doctor :   report immediately to doctor as soon as he gets a sore throat infection
Doctor :   I hope i was able to answer your questions
User :   ok, i will tell my daughter. i don't want to be a nagging grandma, but i think i am. and yes, she takes him to the dr. very soon after he gets a sore throat. however, you did not mention about kidney or heart damage from this, what is your opinion on that?
Doctor :   did you follow my suggestions ?
Doctor :   are you with me?
User :   yes i am...did you get my last question about heart and kidney damage from this??
Doctor :   i am reading it
Doctor :   yes , i do understand your concern as a grand mom , i stil remeber my dear grand mom , as she was very sweet to me
Doctor :   i would want to tell you that recurrent episodes of the infection will complicate it
Doctor :   in leading to kidney and heart problems
Doctor :   but that would be very frequent episodes and the one which do not respond to any type of antibitoics
Doctor :   also we need to check on the tire levels
Doctor :   if the titre is very high
Doctor :   we investigate for other problems
Doctor :   this is very initial and he has taken treatment and responded well as well
Doctor :   so do not worry
User :   what is the titre levels??
Doctor :   titre levels are the lab readings , when we check the strepto antigen antibody levels
Doctor :   to analyse if the infection is severe or present along with throat swab culture
Doctor :   do not worry about them
Doctor :   this is the first time and he has recovered
Doctor :   so i do not feel it is necessary to investiagte further
Doctor :   i feel he must improve his immunity and be careful at school for preventing a re exposure
User :   yes, this is what most concerned me...his immunity....i do hope that can improve.
Doctor :   yes , by age the immunity improves
Doctor :   so he must eat well
Doctor :   did you follow my suggestions ?
Doctor :   i hope i answered your questions
User :   yes, i will pass them on to my daughter, and thank you very much. goodnight.
Doctor :   thanks for consulting me
Doctor :   pleasure here
Doctor :   wish you all a good health
User :   and you also...thank you.
Doctor :   welcome , have a good night
Doctor :   take care
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