Strep throat question

I believe my daughter has been given incorrect information by a friend to
the effect that her son, who had his tonsils removed, cannot now get strep
throat.

Since he has a sore throat today and a low grade temp, she is concerned
about taking him out of the house tomorrow (Xmas). Her doctor will not see
him today.

Any advice would be appreciated.

"Don MacCluskie" wrote in message
t...
I believe my daughter has been given incorrect information by a friend
to
the effect that her son, who had his tonsils removed, cannot now get
strep
throat.

Your daughter WAS given wrong information; those who've had their
tonsils removed can still get strep throat, even though a tonsillectomy
might reduce, somewhat, the likelihood.

Since he has a sore throat today and a low grade temp, she is
concerned
about taking him out of the house tomorrow (Xmas). Her doctor will
not see
him today.

Most sore throats are caused by viruses. If your daughter is very
concerned (both for your grandson and others with whom he'd be in
contact), perhaps she could take him to a free-standing medical clinic
(we have some in our area called "EmergiCare"), to the county health
dept. lab, or to a hospital lab (her pediatrician might be willing to
phone in a request for a strep test). All should do a throat culture at
a reasonable cost, and she should get the results within minutes (from a
"rapid" strep test).

Good luck!

(Here's a very good article on strep throat:
http://www.medicinenet.com/Strep_Throat/page1.htm)

On Wed, 24 Dec 2003 16:49:50 GMT, "JG" wrote:

Most sore throats are caused by viruses. If your daughter is very
concerned (both for your grandson and others with whom he'd be in
contact), perhaps she could take him to a free-standing medical clinic
(we have some in our area called "EmergiCare"), to the county health
dept. lab, or to a hospital lab (her pediatrician might be willing to
phone in a request for a strep test). All should do a throat culture at
a reasonable cost, and she should get the results within minutes (from a
"rapid" strep test).

In our case, for holidays and Sundays, we have decided as a group that
it is reasonable to phone in an order for a rapid strep swab to a
hospital laboratory without seeing the patient if the history is
compatible and there are no concerning symptoms by history of
something more serious such as, say, a peritonsillar abscess.

I must say, though, that doctors at Quik-E-Mart-type urgent care
clinics (we had "Primacare" in Texas) are the ones who, in my
experience, are more likely to look at a throat and skip the lab test,
declaring, "Yup, it looks like strep," and prescribe antibiotics. Then
downstream, of course, panic ensues and all the other neighborhood
kids and/or classmates go to their own doctors with mild symptoms but
reporting a history of "exposure to strep."

I have noticed personally that when a patient comes in for sore throat
claiming a history of "exposure to strep" he almost NEVER has it
himself. I think a positive history of strep exposure seems to
DECREASE the pre-test probability of strep (seriously -- the history
of exposure is less predictive than the triad of fever, headache, and
sore throat without cold symptoms), but, of course, you then feel
obligated to do the test since that's what they came in for, thereby
lowering its positive predictive value, increasing false positives,
and perpetuating the perception that a massive strep outbreak is
occurring when it's not.

PF