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Sore Throat Season: Is it Strep? Do I Need Antibiotics?

Posted on Thu, Nov 03, 2011

By eMedical Urgent Care You’ve tried to ignore it, but every swallow is a chore. You’ve got that big project at work, so there’s no time to be sick. How do you know when a sore throat requires medical attention – or just some hot tea and some R&R? Sore throat, also known as pharyngitis or tonsillitis, is a frequent complaint that brings patients to the urgent care center. I’m going to explain the causes and symptoms of sore throats. To treat them, urgent care centers are a convenient option to get the medical attention you need to get you back to feeling better. Causes of Sore Throats Up to 60 percent of sore throats are caused by viruses. The most common of these are adenoviruses, coxsackieviruses, Epstein-Barr virus, cytomegaloviruses and herpes simplex viruses. The second-most popular type is “strep” throat, which is caused by Streptococcus pyogenes or Group A beta-hemolytic streptococcus (GABHS). Only 5 to 15 percent of adults and 15 to 30 percent of children with sore throats actually have strep throat. Other less frequent causes of a sore throat are fungal infections (oral thrush or candidiasis), HIV-1 infection in the acute phase and gonorrhea. Non-infectious causes of sore throat include heartburn or gastro-esophageal reflux disease (GERD), allergies, post-nasal drip, chemical injuries and smoking. Symptoms of Strep Throat Strep throat most commonly occurs in children aged 5 to 15 years old in the fall and early spring. This usually happens after children come in contract with someone who is infected, like in a classroom or daycare facility, or a family gathering. Classic symptoms of strep throat include:

  • Sudden onset
  • White patches and pus on the throat and tonsils
  • A fever greater than 101˚
  • Difficulty swallowing
  • Tender and swollen lymph nodes in neck
  • Headache
  • Chills and shakes alternating with cold sweats
In children, the above symptoms can be accompanied by nausea, vomiting or abdominal pain. Symptoms of a Virus Signs that the sore throat is caused by a virus include:
  • Cough
  • Runny nose
  • Conjunctivitis (pink eye)
  • Sneezing
Testing and Treatment of Sore Throats Doctors use several methods to determine if a sore throat is in fact strep throat. One of the most reliable methods is the rapid strep test. This test is quick and accurate, and allows treatment to start immediately following a positive result. The American Academy of Pediatrics recommends that doctors perform both a traditional throat culture and a rapid strep test on children. Although it takes 1 to 2 days to get results from a throat culture, because children are more likely to develop strep throat, this dual-testing method provides the most accurate diagnosis. While only a fraction of adults and children with sore throats nationwide actually have GABHS bacterial infections, more than 75 percent are prescribed antibiotics. This practice leads to resistant bacteria, meaning the infection doesn’t improve because it’s gotten used to antibiotics, as well as side effects from treatment, including allergic reactions, diarrhea and yeast infections. Our doctors use rapid strep testing and throat cultures, and follow guidelines for the diagnosis and treatment of GABHS set by the Infectious Disease Society of America. Strep throat responds well to penicillin. It can be given as a single dose injection or in pill form. Other prescription options include amoxicillin, cephalexin and azithromycin. To help relieve the pain and swelling of the throat, your doctor also may prescribe a single dose of dexamethasone, a steroid which is an anti-inflammatory, either by injection or by mouth. Strep Throat Shouldn’t Be Ignored GABHS pharyngitis will improve in a few days even if not treated with antibiotics, but we treat patients so that they feel better faster and are less contagious to others. If left untreated, strep throat can put you at risk for developing rheumatic fever, which can damage the heart valves. Another rare but serious complication is acute glomerulonephritis, an injury to the kidney, which can occur regardless of treatment. If you are on antibiotics and aren’t feeling better or if you’ve developed a rash, jaundice or abdominal pain, contact your doctor immediately, as this might indicate Epstein Barr virus or mononucleosis infection. In most cases, with proper evaluation and treatment, sore throats can be treated quickly and easily, often without antibiotics. If you need medical attention for a non-life-threatening illness or injury, eMedical Urgent Care is open during the evening hours to treat walk-in patients. If you have questions about medical conditions, download iTriage from the iTunes or Android Marketplace, or check out iTriageHealth.com for your healthcare answers.

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Fall Sports: How to Recognize a Concussion

Posted on Thu, Sep 22, 2011

It’s a brisk fall afternoon. You’re sitting in the bleachers, watching your son’s JV football game. In the scuffle during a play he hits his head on the turf. You see him get up a bit slowly, but he shakes it off and lines up for the next play. Should you be concerned? It is estimated there are 3 million head injuries each year related to contact sports, according to the Centers for Disease Control and Prevention. For teens and young adults aged 15 to 24 years, it is second only to motor vehicle accidents as the cause of traumatic brain injuries. Concussions can be caused by mild or more severe blows to the head. They may or may not involve loss of consciousness. Recently, more attention has been placed on recognizing and treating concussions earlier to decrease the risk of long-term neurological damage. The Signs of a Concussion Early signs of a concussion include:

  • Headache
  • Dizziness
  • Nausea or vomiting
  • Confusion
  • Disorientation
  • Vision changes
  • Unequally sized pupils
  • Lack of awareness of surroundings
  • Slurred or incoherent speech
  • Lack of coordination
If your child is injured and shows any of the above signs, he or she should stop participating in the sports activity immediately. The New Jersey State Interscholastic Athletic Association requires that any student athlete who sustains a possible concussion or any loss of consciousness be removed immediately from play. A medical evaluation is required to determine if a concussion was sustained. If it’s determined that your child did have a concussion, he or she must be symptom-free for one week before he or she can return to play. You should seek immediate medical attention if your child’s symptoms persist for more than 10 minutes. If the symptoms are mild, such as mild headache, dizziness, nausea without vomiting or loss of memory for a few minutes, watch to see if the symptoms worsen. The physicians at eMedical Urgent Care can help determine if further care is needed. When to Go to the Emergency Department You should bring your child to the nearest emergency department if the injury involves:
  • Large cuts
  • Prolonged loss of consciousness
  • Severe headaches
  • Drowsiness
  • Inability to walk
  • Slurred speech
  • Seizures
What to Expect After a Concussion A few days to a few weeks after having a concussion your child might experience:
  • A persistent, low-grade headache
  • Light-headedness
  • Poor attention and concentration
  • Memory issues
  • Fatigue
  • Irritability
  • Frustration
  • Anxiety and/or a depressed mood
  • Trouble sleeping

The recovery period for concussions can vary from patient to patient. Some may develop “post-concussion syndrome,” which can last weeks or months and includes chronic headaches, dizziness and nausea.  If your child sustains a more severe concussion, he or she should be seen by a neurologist in addition to your primary physician to manage ongoing care.

 

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