Infectious Causes of Sore Throat

If you ask anybody what is a common pathogen that causes a bad sore throat, strep is probably the answer you will get the majority of the times. However, strep due to GABHS for which a rapid strep test is performed only accounts for about 10-15% of all sore throats overall due to a bacteria. When taking into consideration ALL pathogens, viruses cause the majority of all sore throats. Indeed, viruses cause 85% to 95% of throat infections in adults and children younger than 5 years of age; for th…

4/18/2021 0

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Potential Increased Long-Term Risk of Diseases with Tonsillectomy and Adenoidectomy

The New York Times published a story on June 7, 2018 publicizing a Danish 2018 study that suggested that children under 9 years old undergoing tonsillectomy and/or adenoidectomy  are at increased long-term risk of respiratory, infectious, and allergic diseases. (Adults undergoing this surgery were not investigated.) All prior studies  evaluating for any adverse affects from surgical intervention looked more at any unusual immunological changes after surgery; these studies did not show a…

6/09/2018 0

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Swab Culture is Inaccurate Test for Determining Tonsillitis

A fascinating study came out in June 2017 that compared the bacteria found on the tonsil surface by swab versus bacteria found within a core needle biopsy versus bacteria found within the dissected tonsil's core. The take home finding is that a swab culture poorly identifies the bacteria causing recurrent tonsillitis . Based on 54 children who underwent tonsillectomy , researchers performed a swab, needle biopsy, and core dissection of all tonsils removed. Culture results obtained from…

6/28/2017 0

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Pet Dog May Cause Recurrent Strep Throat

Image courtesy of alex_ugalek at  FreeDigitalPhotos.net In rare situations, strep throat infection bounces repeatedly among all family members. In such situations, the family's pet dog may be the carrier for strep that may cause such recurrent strep infections among the children and parents. See references below. Fortunately, in the vast majority of situations, the pet dog has no role in recurrent strep throat infections . Indeed, many healthcare professionals are in fact skeptical …

8/21/2016 0

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What is the Most Common Cause of Bacterial Sore Throat? (Hint... It is NOT Strep)

Viruses may cause the most sore throats, but when it comes to bacterial sources, strep seems to get a bad rap as THE germ that causes tonsillitis and pharyngitis. However, a 2015 study from University of Alabama suggests that group A strep which is detected by the commonly used rapid strep swab only accounts for about 10% of bacterial sore throats. The real culprit that causes most of the bad non-viral sore throats at least in young adults (15-30 years) is Fusobacterium necrophorum . Th…

5/08/2015 1

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At-Home Rapid Mono Testing

Rapid mono test kits  can be purchased by anybody to be done at home which may save parents/patients money in doctor visits as well as getting an answer right away. Indeed, should mono testing be positive, than you know that the patient is contagious... and that there's not much to do other than give it time to resolve. A doctor visit may still be worthwhile since there are other possible causes of a sore throat including strep throat, cancer ,  aphthous ulcer ,  sinus infection ,  reflux …

1/24/2015 1

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Tonsillectomy "May" Help with PANDAS?

Only in kids, there is a VERY rare (and controversial) disorder where strep throat infections can rapidly lead to involuntary tics including  chronic throat clearing ,  cough , head/neck movements, sneeze, etc as well as OCD behavior. Known as PANDAS ( P ediatric A utoimmune N europsychiatric D isorder A ssociated with S treptococcus), it is felt to be an autoimmune reaction triggered by antibodies produced by the body when fighting a strep infection. With this disorder, an evaluation with…

1/10/2015 1

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At-Home Rapid Strep Testing

Rapid strep test kits can be purchased by anybody to be done at home which may save parents/patients a lot of money in doctor visits for those prone to strep infections . Indeed, should a rapid strep test be positive, than you know that a doctor's visit is definitely worthwhile. (A doctor visit may still be worthwhile since a sore throat may be due to something else like cancer , aphthous ulcer , sinus infection , reflux , etc). Such home kits (which in fact are the same kits used in medi…

11/16/2013 0

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What is the Best Antibiotic for Strep Throat?

The traditional answer for the best antibiotic to treat strep throat is penicillin. This antibiotic works astoundingly well... until it doesn't. Why is that? Although in the lab, penicillin is probably the most effective antibiotic against Group A beta-hemolytic streptococci (GABHS) or "strep throat" infection, when it comes to human beings, it doesn't always work. A recent paper out of Georgetown elucidates the reasons why that might be the case and also explains why …

9/25/2013 0

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Did a Case of Lemierre's Syndrome Influence Super Bowl XLVII?

Image by Keith Allison from Wikipedia Lemierre's syndrome is an exceedingly rare complication of tonsillitis characterized by an infected clot of the jugular vein leading to sepsis. It may also have potentially influenced Super Bowl XLVII due to an interesting quirk in history. Back in 2008, a former Heisman Trophy winner from Ohio State University named Troy Smith was the quarterback for the Baltimore Ravens. Great things were expected of him as he was gearing up to start in th…

9/11/2013 0

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PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus)

Only in kids, there is a VERY rare (and controversial) disorder where strep throat infections can rapidly lead to involuntary tics including chronic throat clearing , cough , head/neck movements, sneeze, etc as well as OCD behavior. Known as PANDAS  ( P ediatric A utoimmune N europsychiatric D isorder A ssociated with S treptococcus), it is felt to be an autoimmune reaction triggered by antibodies produced by the body when fighting a strep infection. With this disorder, an evaluation with a p…

7/12/2013 0

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Periodic Fevers in a Child - PFAPA

Fever in a child is not uncommon. After all, they get a lot of infections whether it be ear infections , tonsillitis , viral syndromes , etc. However, what can be particularly vexing and confusing for both physicians and families is a child who keeps getting recurring fevers every few weeks out of nowhere for seemingly no reason and no obvious infectious source. The typical scenario is a child with abrupt onset of fevers to ~102 degrees F or higher that lasts 3-7 days and just as inexpli…

10/16/2012 0

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Deaths Associated with Codeine Usage in Young Kids

For decades, surgeons have provided young children with prescriptions for pain control after tonsillectomy and/or adenoidectomy surgery, most commonly tylenol with codeine (otherwise known as tylenol #3), but also related narcotics including morphine, lortab, hydrocodone, etc. Millions upon millions of such prescriptions have been filled and taken without any problems, but there is now a growing concern that such narcotics may be causing more harm than good in a small percentage of kids a…

10/14/2012 0

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Tonsillectomy Circa 1940s [video]

I encountered this interesting video of tonsillectomy being performed in a child with sedation (but NO intubation) performed circa 1940s. Of course, nowadays, tonsillectomy is performed under general anesthesia with intubation for airway protection. Below is a video of the way it is now done. That is, unless, you practice in other parts of the world where modern medicine is not up to United States standards. In those nations, tonsillectomy is STILL being performed WITHOUT general ane…

10/25/2011 0

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Twins Die after Tonsillectomy and Adenoidectomy

Twin Ohio boys, 3 years old, both died on April 19, 2006 after both kids underwent tonsillectomy & adenoidectomy  (T&A) less than 48 hour earlier. Both children were discharged home on the same day of surgery. Read the story here . On Aug 6, 2010, a malpractice suit was found against the otolaryngologist who performed the surgery, based on the assertion that if the surgeon "kept the children in the hospital overnight - something within his power and a standard practice for chil…

1/08/2011 1

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Clinical Guidelines For Tonsillectomy in Children Published

This month, the American Academy of Otolaryngology-Head & Neck Surgery published clinical guidelines for tonsillectomy in kids. No big surprises in the guidelines, but everything is nicely summarized in one document. In summary: • Strong recommendation that clinicians should administer a single, intraoperative dose of intravenous dexamethasone to children undergoing tonsillectomy . • Strong recommendation against clinicians routinely administering or prescribing perioperative antibi…

1/05/2011 0

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Teenager Dies From Tonsillitis

A teenager in the United Kingdom died from an unfortunate missed diagnosis of tonsillitis . Apparently, her primary care doctor thought she had swine flu and was prescribed tamiflu... an anti-viral medication. For bacterial tonsillitis , treatment is with anti-bacterial antibiotics like amoxicillin, penicillin, etc. The tonsil infection spread into her blood, seeded her lungs, and eventually caused multi-organ failure and death. Read the full story here .

11/03/2010 0

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TV Show "Glee" Character Rachel Has Laryngitis? Tonsillitis?

On May 11, 2010, Glee aired its eighteenth episode titled "Laryngitis". In this episode, Rachel suffered from a lost voice which was attributed to tonsillitis or is it laryngitis . It was a bit confusing as it would seem her lost voice was attributable to laryngitis (title of the episode), but than she was diagnosed with tonsillitis by the TV doctor which really has nothing to do with laryngitis. I guess it is possible that she had TWO conditions going on at the same time even tho…

5/12/2010 1

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NYT: Wolfgang Amadeus Mozart Death Due to Strep Throat?

Image by Wikipedia Well according to a NYT article published on Aug 17, 2009, yes he potentially did. In the article titled "What Really Killed Mozart? Maybe Strep ," the journalist reports on a paper published in the Aug. 18 issue of The Annals of Internal Medicine where the researchers have done an epidemiological analysis that suggested he was a victim of an epidemic streptococcal infection. Read the NYT article here . Read the actual paper abstract here . This story illus…

8/17/2009 0

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New Video on Coblation Tonsillectomy

Fauquier ENT has produced a new video on coblation tonsillectomy for patient educational purposes. It has been added to our YouTube page as well as below. The video shows 3 different views of the procedure, each view being more magnified. It's a little over 2 minutes long in its entirety. Check it out!

12/18/2007 0

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