Talk:Streptococcal pharyngitis

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[edit] See also - really?

In the See Also section, I found this:

Herpes, as the symptoms of these two ailments are very similar, do not mistake one for the other.'

I know I'm not a doctor, so maybe I'm missing something, but how exactly are these two diseases have similar symptoms?? Is this vanadlism, or perhaps a serious edit by a person who wrote this thinking about mononucleosis (HHV-4) rather than Herpes Simplex (HHV-1 or HHV-2) which are what we normally called Herpes? In that case, it's a good thing Chicken Pox (HHV-3) wasn't also added to the "See Also" list ;-) 84.108.167.132 (talk) 12:25, 19 February 2008 (UTC)

[edit] It is delicious cake. You must eat it.

There was this sentence in the "Transmissions" section: "The cake was made of 3 layers of bread with filling, which consisted of mayonnaise, caviar, cream, mimosa salad, liver pate, and cucumber, and there was a layer of mayonnaise, ham, meatballs, eggs, and prawns." Obviously this was false, and I deleted it. However, what about the other data about the cake? Is that verified?

68.38.225.254 (talk) 03:49, 16 January 2008 (UTC)Sharon

[edit] Discussion

Just a quick Q, but how is that image in any way indicative of strep throat vs. a viral infection? You're just going to confuse people.

I think the sources should be cited for this page- how do we know if it's accurate? Emily 00:07, 8 March 2006 (UTC)

Perhaps Web MD Strep Throat page should be cited? It's showing on my browser as http://www.webmd.com/hw/strep_throat/hw54747.asp but this might not be a permenant link. Joncnunn 13:26, 6 April 2006 (UTC)

[edit] Virus?

"If left untreated, the strep throat virus can lead to post-streptococcal glomerulonephritis, or failure of the kidneys." But, strep isn't a virus, it's a bacteria, according to the rest of the article. Jsnow 05:01, 8 March 2006 (UTC)

I'm going to go ahead and replace the word "virus" with "bacteria" just to be on the safe side for now. If anyone can shed some light on this, please do so. TuckJ 00:07, 9 March 2006 (UTC)TuckJ 0:06 9 March 2006 (UTC)
It's certainly a becterium, not a virus. Just an error, thanks for fixing it. 192.116.237.116 15:02, 31 July 2006 (UTC)

[edit] Rapid test

I had strep throat once, my whole week of spring break. No partying for me. I was stuck at home, sleeping all day long, then I got a nice big penicilling shot in my behind.

"The throat of the patient is swabbed for culture or for a rapid strep test (5 to 10 min) which can be done in the doctor's office." That is, taken and sent to lab for results, or can the general practitioner see the results immediately? Xerai 14:07, 17 May 2006 (UTC)

I had it last week, and it's immediate. He left with a swab and returned a few minutes later saying the test was positive for strep.

From the article: In the UK, rapid strep testing is not available to general practitioners

Why not? — Omegatron 19:34, 7 November 2006 (UTC)

I removed the discussion of: "then I got a nice big penicilling shot in my behind." "It's spelled penicillin, not penicilling.." "Sentences don't end in two periods, either. Let's not be elitists with flawed grammar." It's completely irrelevant to the discussion, but rather just hateful Jitunu 03:22, 10 April 2007 (UTC)

I have been told by my GP that the rapid test is often inaccurate, inclined towards giving false negatives. Twice at school I have contracted strep throat, and twice tested negative at the school health centre with the 'rapid' test (and been given a lecture on how not every sore throat is strep), only to go to my GP a couple days later and get a Dx of strep, put on antibiotics, and the sent-out swab comes back positive. Once is a mistake...twice is just stupid. My advice would be to go pay for the real test at a real doctor's; don't waste your time (and possibly money -- the rapid test I get for free at my school) on the rapid test. A lot of walk-in clinics use the rapid test, too. Ask for the real one. —Preceding unsigned comment added by 172.163.140.28 (talk) 05:23, 26 September 2007 (UTC)

[edit] Questionable statement

The article contains a sentence about a different disease: "Mononucleosis itself, however, can be extremely dangerous if left untreated.". Ah? The Mononucleosis article seems to explain that this is a very common and while it is not pleasant, it is far from "extremely dangerous". Also the article explains the it is a virus, and that no treatment is known. So almost every part of the sentence in this article appears false... 192.116.237.116 15:02, 31 July 2006 (UTC)

I agree. Treatment for mononucleosis is supportive, and current antivirals apparently make little difference in the course of the illness. Whatever the case, the statement is off topic in an article about strep throat. I'm going to go ahead and delete it since no one has offered a reply to the above post. 71.221.255.155 03:55, 14 November 2006 (UTC)

[edit] Questionable statement

"In the UK, rapid strep testing is not available to general practitioners and a clinical decision must be made whether to treat while waiting up to 7 days for a swab result to be reported, treat without confirmation from tests, or wait for confirmation. This is criticized for encouraging overuse of antibiotics (see antibiotic resistance)."

Better: "The UK does not have the same tradition of concern about strep throat, and a general practitioner may not understand why a mildly sick patient would visit the surgery instead of using home remedies or over-the-counter drugs."

Reference the NHS Direct website which tries to advise people when they need to visit a paid-for-by-taxes doctor (as opposed to US references on when to visit one who will make money from the visit). http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=343&sectionId=7066

Do you really believe that the occasional really sick UK child given unnecessary antibiotics causes more drug resistance than every US schoolchild receiving repeated courses of antibiotics supposed to be taken for 10 days when they are usually better in a couple of days and thus many courses are not completed, potentially leaving resistant bacteria in each such child?

Oak 15:30, 7 November 2006 (UTC)

That would be incorrect. You have cited "sore throat", you should look under "streptococcal infections", which states "streptococcal infections are treated with antibiotics". The condition is not something of the sort where one can get better without antibiotics, instead it will "led to serious conditions such as rheumatic fever (infection affecting the heart and joints)". I know quite a bit about the subject; I have been infected three times within the past three and a half months and now my tonsils must come out otherwise another infection may lead to a critical level of antibodies from my immune system resulting in them attacking my heart and joints. Oddly enough, my strep throat cases have largely been atypical, with only a mild sore throat for a day or so and no fever at all, the only clue I had was the pus accumulating on my tonsils. 71.219.93.220 06:14, 23 December 2006 (UTC)
To be honest I have NEVER heard anyone in the UK talk about Strep Throat - I think the page should reflect this some how - we simply have a sore throat --C Hawke 11:58, 30 April 2007 (UTC)
If it is a bacterial infection, would it not be the same as tonsillitis? I currently present all the symptoms for "strep throat" and have been diagnosed with tonsillitis, and am taking liquid penicillin. I believe that strep throat is just referred to as being the same as tonsillitis here in the UK. Josh 04:00, 16 June 2007 (UTC)

[edit] Symptoms

The following is taken from the section titled symptoms-- Drinking hot liquids helps. Orange juice and grapefruit juice should not be consumed, because the acids in them may irritate the throat. These two sentences are about treatment and should be moved out of the symptoms section as they have nothing to do with symptoms. —The preceding unsigned comment was added by 213.65.230.31 (talk) 15:21, 3 February 2007 (UTC).

I removed the sentence "Drinking hot liquids helps." I see no references backing this statement, so I opted not to move it into Treatment, either. I feel the second sentence, "Orange juice and grapefruit juice should not be consumed, because the acids in them may irritate the throat" is obviously off topic, but irritation of the throat due to already having the illness can still be viewed as a symptom. So, maybe just rephrase it to present the actual symptom first in the sentence? Jitunu 03:20, 10 April 2007 (UTC)
Drinking hot liquids does help, as I currently am experiencing this, and I have found hot liquids to control pain in my throat. However, I can't find any sources to confirm this to wikipedia standards. Oh well. :~) Josh 04:04, 16 June 2007 (UTC)

[edit] Penicillin

This treatment section makes a pretty strong statement about penicillin being the standard of care. I am not a physician but my family and I have suffered strep infections more than once and never been prescribed penicillin. My wife, a nurse, indicates that this is definitely not standard in the U.S. any longer.

Presumably this needs to be changed (preferably by somebody more knowledgeable than me). Mcorazao 20:35, 30 March 2007 (UTC)

I don't think that's true everywhere in the US. My family, my sister's, and her boyfriend's family just went through a repeating bout of strep throat (the docs figured out it was drug-resistant) and all of us who weren't allergic were given penicillin. Our doctors all said that was standard. And we do live in the US.
In the UK, penicillin is the standard of care. Liquid penicillin is prescribed for those who have problems swallowing. Josh 04:05, 16 June 2007 (UTC)

[edit] Strep throat and obsessive-compulsive disorder (OCD)

I heard an online program once (http://www.abc.net.au/rn/allinthemind/stories/2006/1789076.htm) and also seen in a Discovery Channel video called "All You Need To Know About, The Brain" that bacteria from strep throat can cause OCD if it enters the brain. I don't know anything else about it but I supplied a link to that radio program which talks about that. I think it should be mentioned - as some children who get strep throat, sometimes become OCD.

[edit] Technically correct but useless

The section on diagnosis may be technically correct (not that I could tell one way or another) but it's extreme and excessively technical derivation is useless to the majority of the public. If you can't come up with a "common person" summary, you might as well delete it.

[edit] UK usage

As mentioned by another editor above (in the "Questionable statement" section) the phrase "strep throat" is much less commonly used in Britain than it is in the US - it will be used by doctors when a precise description is needed, but is rare in everyday speech. Indeed, the NHS Direct page dealing with streptococcal infections has to say "strep throat (sore throat)" on the first appearance of the term, to make sure lay readers know what's being discussed.

Note also that although that NHS Direct page does indeed mention antibiotic treatment as standard for streptococcal infections, the more general NHS Direct page on sore throats in general says that "It is extremely rare for antibiotics to be needed. This is only the case when the sore throat is the result of a serious bacterial infection." And this BMJ page is entitled simply "Sore throat (Strep throat).

I have a feeling, though can't prove it, that usage of the phrase "strep throat" has increased somewhat in the UK since the advent of the internet (which has made many US-English phrases more recognisable here). But I was at a large UK university for several years in the mid-1990s, and I don't think I ever heard the term used except by a doctor or nurse. I did ponder sticking a "globalize" tag on the article, as it is US-centric in this regard, but I don't think it's all that serious. It would be nice to have a little about UK practice, though. 86.136.255.6 22:57, 28 May 2007 (UTC)

I'd agree, I consider the term almost unheard-of in common parlance in the UK. Cheers, DWaterson 22:30, 10 August 2007 (UTC)


ya, me n all, never heard of it before I started chatting to americans online, in the UK it would just be 'sore throat' Restepc 03:01, 22 September 2007 (UTC)

[edit] International precise names take priority over US slang

"Strep throat" is just an abbreviated term. As per WP:MEDMOS, "The article title should be the scientific or recognised medical name rather than the lay term" and goes on to indicate one should use "The World Health Organisation International Statistical Classification of Diseases (ICD 10)". Hence just as the article is Myocardial infarction and suitable redirects are provided, so this article should be named as per the given J02.0, i.e. "Streptococcal pharyngitis", although suitable additional term "Streptococcal sore throat" is given which allows at least some variation in usage of terms in the article for a better read. The article needs aggressive copyediting: removing chatty style "like in one study", instruction and direct reader advice, list of symptoms jumping from throat to systemic effects and back again. As a start rename to correct term "Streptococcal pharyngitis". David Ruben Talk 22:25, 4 April 2008 (UTC)

[edit] Red and Black(?) Dots

I believe there is a factual error in the article, and as I don't want to presume to know more than the author, I've chosen to raise the issue in discussion rather than edit the page directly.

The article mentions symptoms including red and black dots, but I don't think this is correct. One of the sources of the article, a fact sheet from US National Institute of Allergy and Infectious Diseases, states the following:

"If you have strep throat infection, you will have a red and painful sore throat and may have white patches on your tonsils." [1]

Though I've never heard of black dots as a symptom of strep throat, that doesn't mean they're not. Can anyone else confirm this? Either way, I'm certain that white patches (pustules) are a symptom of the illness. As I had strep throat numerous times as a child, and my son comes down with it every spring, first-hand experience also confirms this. Qmendoza 22:07, 24 August 2007 (UTC)

[edit] Early Detection of Strep Throat

As a child, I had strep many times until my tonsils were removed. After about the second time (at around 6 yrs of age), I found that when eating certain foods (specifically a pear and a butter cookie) I could detect the strep bacteria before I had any of the commonly reported symptoms, by a terrible after-taste that would be present after eating either of the two foods listed above. On one occasion, at about age 10, I reported this "taste" and predicted that I had strep, but the throat culture results were negative. Within 48 hours, I began to present with more symptoms, and a follow-up culture was positive. This occurred consistently through at least 15 episodes of strep throat that I can remember, but I have never seen that listed as a symptom anywhere. Has anyone else who frequently experienced strep had a similar observation? —Preceding unsigned comment added by Thomajam (talk • contribs) 13:58, 7 September 2007 (UTC)

[edit] The overuse of Antibiotics

As a Swedish medical student currently doing rotations on a GP clinic I would like to take the opportunity to describe the Swedish approach to the Strep tonsillitis issue.

The developing antibiotics resistance is a major problem in the world today, perhaps the biggest medical challenge in the future. This is a fact that us medical students are brainwashed with. Even though it is undoubtedly less of a problem in Sweden than in other European countries, big efforts are made to bring down the use of antibiotics. One of the ways is to reduce treatment of tonsillitis and otitis media (ear infection).

What we are taught is to not treat these infections with antibiotics (usually PcV), unless:

  • The patient is less than 2 years old
  • The patient has problems with eating and/or breathing because of the swelling
  • Symptoms are severe, as in high fever.
  • The disease is relapsing.

Studies show that usually a treated tonillitis patient only gains 1 or 2 days in comparison with the untreated patient. And since complications of the sort mentioned before are extremely uncommon these days (maybe that's just here? I don't know...) that is hardly even taken into account.

What are the policies in your countries? Zaimon 10:15, 5 October 2007 (UTC)

I am not a doctor, but the standard of treatement seems to be moving somewhat in that direction in the US. Mild strep infections are sometimes allowed to cure, but there is stilla a rheumatic fever controversy. Pawsplay (talk) 13:39, 21 March 2008 (UTC)

In the U.S., antibiotics are the standard treatment - usually penicillin or erythromycin. I don't think it's wise to "allow it to cure" on its own (this is also the position that almost every doctor in the US takes). Usually the infection will just get worse if left untreated, and since it's bacteria, you can reinfect yourself or others. I wouldn't say that using the two standard antibiotics I've mentioned qualifies as "overuse" of antibiotics. Fuzzform (talk) 23:23, 31 March 2008 (UTC)

[edit] Illustration

An additional photographic image is needed to illustrate a case of Strep Throat in which the tonsils are coated with the white patches or streaks of pus. Copyright issues make adding an image a complex undertaking. Greater detail is also needed in the general description of the disease, directed toward the layman. SDBrewer (talk) 19:21, 29 November 2007 (UTC)SDBrewer

The current image is pretty bad. White spots are indicative of strep, and the picture not only shows no white spots, but it shows no clear indication of strep. Next time I get strep (which will hopefully be never), I'll take a picture of my throat. The white spots are what allowed me to diagnose it in the past, both in myself and others. See the comments above for a citation about these white spots. Fuzzform (talk) 23:13, 31 March 2008 (UTC)
Actually, that looks like a pretty good picture of strep. Whenever I go to my doctor with a sore throat, she sometimes says to my mom, "Well, there is no redness, so it's not strep." I can infer that a red throat indicates strep throat, and this throat is PRETTY red! Besides, I don't know how we can get another picture. --Listen to your Princess, dear Wikipedians. (talk) 18:25, 4 April 2008 (UTC)