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Medical Forum / General / General / July 2007strep throat treatment
I just found out from a nurse while attempting to donate blood that I appear to have strep throat (a bunch of white spots just formed on my tonsils and a fever has begun). Having no insurance or way to pay for a doctor visit, what is the best way to deal with strep? Is plenty of fluids, vitamins, and sleep good enough? If you do not treat this with penicillin, which is prescription and cheap (many pharmacies in our area are offering this for free with a prescription) you risk having a possible kidney problem in the future if it is Group A beta strep. There are other strep groups that can give you the symptoms you describe, and make you feel lousy, but won't give you the kidney scenario. Unfortunately a culture or rapid test needs to be performed in order to tell. I would investigate your local Health Department - they have a lot of free clinics. Do this ASAP. Judy Dilworth, M.T. (ASCP) Microbiology >I just found out from a nurse while attempting to donate blood that I > appear to have strep throat (a bunch of white spots just formed on my > tonsils and a fever has begun). Having no insurance or way to pay for > a doctor visit, what is the best way to deal with strep? Is plenty of > fluids, vitamins, and sleep good enough? > If you do not treat this with penicillin, which is prescription and > cheap (many pharmacies in our area are offering this for free with a [quoted text clipped - 15 lines] >> a doctor visit, what is the best way to deal with strep? Is plenty of >> fluids, vitamins, and sleep good enough? 1) It's hard to be sure clinically that this is strep. Viral sore throats can look like this too. 2) I don't know of any evidence that antibiotic therapy reduces the likelihood of kidney problems (PSGN) after strep throat. 3) The main argument for treating strep with antibiotics is to prevent rheumatic fever, though this is a rare complication these days. 4) Antibiotics might also decrease the risk of someone with a strep throat developing a peritonsillar abscess.  SignatureDavid Rind drind@caregroup.harvard.edu http://dentalresource.org/topic56scarletfever.html Glomerulonephritis can also be a problem with Group A beta strep infections that lead to scarlet fever, in addition to rheumatic fever. Yes, it is difficult to determine if this is viral or streptococcal over the internet. Judy Dilworth, M.T. (ASCP) Microbiology > 1) It's hard to be sure clinically that this is strep. Viral sore > throats can look like this too. [quoted text clipped - 7 lines] > 4) Antibiotics might also decrease the risk of someone with a strep > throat developing a peritonsillar abscess. >> 1) It's hard to be sure clinically that this is strep. Viral sore >> throats can look like this too. [quoted text clipped - 7 lines] >> 4) Antibiotics might also decrease the risk of someone with a strep >> throat developing a peritonsillar abscess. > http://dentalresource.org/topic56scarletfever.html > [quoted text clipped - 6 lines] > Judy Dilworth, M.T. (ASCP) > Microbiology This would be easier to follow if you didn't top post. I'll cut and paste to move my earlier post to the right place. I didn't say that strep can't cause glomerulonephritis ("PSGN" in my post above is "post-streptococcal glomerulonephritis). I said that I don't know of any evidence that treating strep with antibiotics reduces the risk of this complication. I could have said it more strongly: there is no good evidence that treating strep throat helps prevent PSGN. SignatureDavid Rind drind@caregroup.harvard.edu Fine. Whatever. Judy Dilworth, M.T. (ASCP) Microbiology > Fine. Whatever. > > Judy Dilworth, M.T. (ASCP) > Microbiology I'm assuming that was in response to my post. When I post misinformation to sci.med, I hope someone who spots that what I wrote was wrong will post a correction. What are you hoping people will do when you post misinformation? SignatureDavid Rind drind@caregroup.harvard.edu > > "David Rind" <dr...@caregroup.harvard.edu> wrote in message > >news:f7bsma$etb$1@reader2.panix.com... [quoted text clipped - 37 lines] > David Rind > dr...@caregroup.harvard.edu It is basically implied and don't know of any direct studies except this animal model. Anything new studies out there? 1: Acta Pathol Microbiol Immunol Scand [C]. 1983 Aug;91(4):271-81. LinkOut Effect of early penicillin treatment on the development of experimental poststreptococcal glomerulonephritis.Bergholm AM, Holm SE. A newly developed experimental model in which poststreptococcal glomerulonephritis (PSGN) was established in rabbits utilizing viable group A streptococci, was used to study the possibility of hindering the development of renal disease by early penicillin treatment. The development of renal injury was followed by proteinuria, creatinine clearance, histological and immunological examinations of the kidneys. Therapy within the first 3 days of infection with i.m. pc-G prevented the nephritic process. PMID: 6356782 [PubMed - indexed for MEDLINE] 1: Monatsschr Kinderheilkd. 1992 Aug;140(8):490-2. LinkOut [Has post-streptococcal glomerulonephritis disappeared?][Article in German] Latta K, Ehrich JH, Brodehl J. Kinderklinik Medizinischen Hochschule Hannover. We report on 21 children with poststreptococcal glomerulonephritis (PSGN). The diagnosis was based on clinical and laboratory criteria. 19/21 had a clinically apparent throat infection initially, but only 6 received antibiotic treatment. Initial symptoms were: macrohematuria (20/21), edema (10/21), arterial hypertension (6/21), reduced creatinine-clearance (11/21), and proteinuria (18/21). No Patient was dialyzed. After an interval of 0.3 to 25 months 19 children are asymptomatic. All patients have normal creatinine-clearances; none is hypertensive. The present data show that PSGN has not disappeared in Mid-Europe. Remarkable acute disturbances occurred, which healed in almost all cases. The importance of accurate bacteriologic diagnosis and adequate therapy is emphasized. PMID: 1435810 [PubMed - indexed for MEDLINE] >>I didn't say that strep can't cause glomerulonephritis ("PSGN" in my >>post above is "post-streptococcal glomerulonephritis). I said that I [quoted text clipped - 45 lines] > > PMID: 1435810 [PubMed - indexed for MEDLINE] I don't have access to the rabbit study, but would wonder about the timing of the infection and the treatment. There are lots of complications of diseases that you can prevent in an animal model if you start treatment at the moment of injury or infection, but that don't translate to humans where treatment can't start until the infection becomes clinically apparent. No one is likely to perform an RCT since we treat strep throat to prevent RF and to speed recovery. The OP was trying to avoid seeing a doctor for an illness that may or may not have been strep. While everyone would advise him that it's safer to see a doctor, I don't think anyone would think that it's likely to go badly if he doesn't. If he really has strep, he's at some small risk of developing RF if he doesn't get treated. His risk of PSGN is quite low, and we really don't know that we can modify it at all by treating him. SignatureDavid Rind drind@caregroup.harvard.edu |
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