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Child diagnosed with strep throat by swab test and having rash but no problem with tonsils. Advise?

Feb 2013
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Practicing since : 2002
Answered : 3176 Questions
My grandson has been diagnosed for the 7th time since March with Strep. This was determined by an instant swab with no further tests. He also is covered with the scarlet rash. His Dr. says that you do not do a culture is strep is positive but only if negative!!! He has several other symptoms, but nothing is showing wrong with his tonsils as per his Dr. PLEASE HELP!!!!!
Posted Tue, 9 Jul 2013 in General Health
Answered by Dr. E Venkata Ramana 1 hour later

Thank you for your query on Healthcare Magic.

Culture and sensitivity of throat swab is the gold standard test in diagnosing the streptococcal throat infections.

But an instant swab test also detects the streptococcal infection.

The advantage of the culture and sensitivity is it will guide in choosing an appropriate antibiotic in treating the infection.

What is the present status of the child?

Is he having fever, throat congestion which are suggestive of throat infection?

In view of repeated streptococcal infections, his cardiovascular system has to be examined and evaluated.

Investigations like ECG, and 2D Echo will rule out any heart related abnormalities which are sometimes associated with recurrent streptococcal throat infections.

Hope I have answered your query, if you have any clarification please let me know in the follow up query along with the details I have asked.

Above answer was peer-reviewed by
Follow-up: Child diagnosed with strep throat by swab test and having rash but no problem with tonsils. Advise? 19 minutes later
He states that he has shortness of breath and it is hard for him to swim because the water feels "too heavy" on his chest. He has no fever at this time and I seemed to catch a slight throat congestion when he talks, but no one else has mentioned that . I have just noticed it. You have really given me alot of food for thought!! I have never thought of heart conditions but his comes from a family of STRONG heart disease. His dad has a murmur and his grandday died at age 48 with heart attack, his great-granddad died early in age with a heart attack after several strokes. His dad's brother is 38 and has been diagnosed with atrial fib with uncontrolled ventricular response. I, his grandmother, has hbp. Sooooo
much heart disease in his family.
Answered by Dr. E Venkata Ramana 21 minutes later

Thank you for getting back.

Shortness of breath is due to over exertion while swimming.

Why I advise to go for his heart evaluation is - there is relation of some heart problems like rheumatic heart disease with streptococcal throat infections.

As the child is asymptomatic at present without fever and throat infection, antibiotics are not required.

But you can discuss with his pediatrician regarding repeated streptococcal throat infections and plan for relevant investigations with his advice.

Hope I have answered your query, if you have any clarification please let me know.

Above answer was peer-reviewed by
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