Head to Toes, Part 3: Strep Throat
One of the most common reasons people seek medical attention is for a sore throat, a medical condition can be caused by many, many things. The vast majority of sore throats are self-limiting viral (80-85%) infections; the rest are caused by Strep or a wide variety of other organisms and conditions.
Streptococcal pharyngitis (Strep throat) is most common in children between the ages of five and 15 years old, but can really occur at any age. I occasionally see Strep in children under age five, and nearly all of them are in day-care or pre-school - places where pathogens are shared more freely than toys.
Most people do not realize that between 8 and 20% of children in school or day-care carry Strep in their throats all of the time. They are called asymptomatic carriers. Strep may be spread by direct contact, fomites (freshly-contaminated objects), and by airborne droplets.
In the era before antibiotics, Strep was certainly something to be feared, since it had the nasty habit of causing serious or even fatal complications in the heart, kidneys, and other organs. Another complication, acute rheumatic fever (ARF) was very commonplace during the pre-antibiotic period. When penicillin became available in the 1940s, Strep complications became much less prevalent, and they are rarely seen in the U.S., Canada, and Western Europe. However, when I tell a patient that their culture or Strep test is positive, there is still that feeling of impending doom.
Most adults have had Strep many times in our lives without knowing it, and our immune systems have quickly brought it under control. In the past, throat cultures were the only way to determine if a person had Strep. Cultures take at least two days to come back, so it was not uncommon for a person, now completely well, to be called on day four or five and informed that they have (had) Strep. Now, with the use of Rapid Strep Tests, we can find out in minutes. A throat culture is 100 percent accurate. A Rapid Strep Test is only about 85-90% sensitive. There is only one problem with rapid detection: When you find out quickly on the first day of your sore throat and immediately receive treatment, you circumvent the normal antibody response, actually making you MORE susceptible to Strep infections in the future. Your body never had a chance to fully develop its own antibody response.
Waiting a few days with a plain 'ol sore throat before seeing your medical provider is just fine and will not put you at any unusual risk of developing complications. If your Rapid Strep Test is negative, and the medical provider strongly suspects Strep, then a culture should be taken. If the culture is negative, YOU DO NOT NEED ANTIBIOTICS. Since the vast majority of sore throats are due to viruses, antibiotics are not clinically indicated.
Seeing white stuff on the tonsils is not a reliable clinical sign of Strep. Many things, including viruses, mononucleosis, and even trapped food particles can leave white residue on the tonsils.
The most accurate clinical finding in Strep throat is petechiae - tiny, irregularly-shaped, ruptured blood vessels present on the palate (roof of the mouth) or uvula. The throat is typically beefy-red and the breath can be foul. (Actually, Strep may have a characteristic smell that many seasoned medical providers can detect.) The tonsils and neck lymph nodes are enlarged and tender. Fever is usually present and the onset of the sore throat was relatively rapid. Children with Strep often have vomiting and abdominal pain.
The cure rate for Strep is excellent if you are compliant with your antibiotics. People who stop their antibiotics as soon as they feel better, or share them with other family members are more likely to have relapses or treatment failure. Penicillin (inexpensive and still the drug of choice), amoxicillin, Keflex (cephalexin), erythromycin, Zithromax, and others will quickly cure Strep throat. You are no longer considered contagious 24 hours after starting your antibiotic treatment.
The primary reason antibiotics are prescribed for Strep is to prevent those rare complications, although people on antibiotics do seem to get better sooner.
Related Topics: Know When Antibiotics Work, Kids Flu Survival Guide
Technorati Tags: sorethroat, strepthroat, childhoodillness, antibiotics
Streptococcal pharyngitis (Strep throat) is most common in children between the ages of five and 15 years old, but can really occur at any age. I occasionally see Strep in children under age five, and nearly all of them are in day-care or pre-school - places where pathogens are shared more freely than toys.
Most people do not realize that between 8 and 20% of children in school or day-care carry Strep in their throats all of the time. They are called asymptomatic carriers. Strep may be spread by direct contact, fomites (freshly-contaminated objects), and by airborne droplets.
In the era before antibiotics, Strep was certainly something to be feared, since it had the nasty habit of causing serious or even fatal complications in the heart, kidneys, and other organs. Another complication, acute rheumatic fever (ARF) was very commonplace during the pre-antibiotic period. When penicillin became available in the 1940s, Strep complications became much less prevalent, and they are rarely seen in the U.S., Canada, and Western Europe. However, when I tell a patient that their culture or Strep test is positive, there is still that feeling of impending doom.
Most adults have had Strep many times in our lives without knowing it, and our immune systems have quickly brought it under control. In the past, throat cultures were the only way to determine if a person had Strep. Cultures take at least two days to come back, so it was not uncommon for a person, now completely well, to be called on day four or five and informed that they have (had) Strep. Now, with the use of Rapid Strep Tests, we can find out in minutes. A throat culture is 100 percent accurate. A Rapid Strep Test is only about 85-90% sensitive. There is only one problem with rapid detection: When you find out quickly on the first day of your sore throat and immediately receive treatment, you circumvent the normal antibody response, actually making you MORE susceptible to Strep infections in the future. Your body never had a chance to fully develop its own antibody response.
Waiting a few days with a plain 'ol sore throat before seeing your medical provider is just fine and will not put you at any unusual risk of developing complications. If your Rapid Strep Test is negative, and the medical provider strongly suspects Strep, then a culture should be taken. If the culture is negative, YOU DO NOT NEED ANTIBIOTICS. Since the vast majority of sore throats are due to viruses, antibiotics are not clinically indicated.
Seeing white stuff on the tonsils is not a reliable clinical sign of Strep. Many things, including viruses, mononucleosis, and even trapped food particles can leave white residue on the tonsils.
The most accurate clinical finding in Strep throat is petechiae - tiny, irregularly-shaped, ruptured blood vessels present on the palate (roof of the mouth) or uvula. The throat is typically beefy-red and the breath can be foul. (Actually, Strep may have a characteristic smell that many seasoned medical providers can detect.) The tonsils and neck lymph nodes are enlarged and tender. Fever is usually present and the onset of the sore throat was relatively rapid. Children with Strep often have vomiting and abdominal pain.
The cure rate for Strep is excellent if you are compliant with your antibiotics. People who stop their antibiotics as soon as they feel better, or share them with other family members are more likely to have relapses or treatment failure. Penicillin (inexpensive and still the drug of choice), amoxicillin, Keflex (cephalexin), erythromycin, Zithromax, and others will quickly cure Strep throat. You are no longer considered contagious 24 hours after starting your antibiotic treatment.
The primary reason antibiotics are prescribed for Strep is to prevent those rare complications, although people on antibiotics do seem to get better sooner.
Related Topics: Know When Antibiotics Work, Kids Flu Survival Guide
Technorati Tags: sorethroat, strepthroat, childhoodillness, antibiotics
50 Comments:
Dear Dr. Moser,
I am very concern. I really believed my son who is 5 years old had strep throat 2 weeks ago followed by scarlet fever. Of course, at the time, I thought it was the flu but having read thoroughly what the symptoms now I am convinced that was what he had. His symptoms of high temperature, sore throat lasted 3 days and then a rash appeared from head to toe which lasted 2 days. It really frightens me now to know that the bacteria may damage his kidney and immune system. Is there anything that can be done now.
Sincerely,
E.Lau
My son is 7 years old. He has a history of sensory integration issues. He saw an o.t. for 2 years and was dismissed, meeting all goals. (This was 3 months ago) around a year ago, he tested positive for strep through 2 rounds of anti-biotics, then he wasn't better.. and he had mono. Now almost a year later, he out of the blue started acting like he has A.D.D. or something. He had a blood test and his anti-strep antibioties are 1500. (This after another round of antibiotics..) We are willing to do any treatment to address this number and get his antibioties to "normal"..what do you recommend? What about the removing of circulating anti-strep antibioties? Which antibiotic should he be on? Could this reflect an overall immune disibility? Thank you..a very worried parent, Jenny
Dear Dr. Moser,
I take care of a nine year old boy with enlarged tonsils and aednoids. I believe he should have them removed. Last year he suffered 3 bouts of strep throat. The year before that again 3. He has also had a total of 10 ear infections. The docotor says he needs to have 4 in one year before removing them. I disagree because there are other factors going on which his mother does not mention. He has speech problems, dental issues, exhibits ADD behavior(I know he doesn't have it, he can settle down when he wants to. could be ODD), bed wetting, focusing, lack of endurance(can not keep up with the other kids in physical activity), chokes if he drinks or eats to fast), when he eats foods like raviolis, pudding etc... he has a messy face(this usually quits happening after 6yrs. old), struggles with weight gain(burns a lot more calories just to breath), drools when running, and I believe(I know)he has sleep apnea(from what I have read and observation with a friend. The reason I am writing is I am concerned for his health. I've read some info. on the internet regarding some of the health risks and I wish I would have made copies. If you could send me to a site regarding all the health risk or could inform me yourself would really appreciate it. His mother has huge fears regarding surgrey, but if I could give her info. regarding the risks if he doesn't she may change her mind. Or if I am totally off, let me know that to.
Thank you!!!
Dr. Moser,
My 4 year old daughter has recently been diagnosed as a strep carrier. She has had vaginal strep, not throat strep, numerous times over the past 30 months. If the vaginal strep is not treated with antibotics quickly, staph sores begin to produce. The Dr. has tested the staph boiles and the results came back MRS staph. However, they cultured her recently to see if she was a carrier of MRS staph, and the results came back negative. The next step is to talk about removing her tonsels to remove the strep from her system--as she is a carrier of strep. Does strep on her tonsels produce strep on her vaginal area and will this procedure eliminate her vaginal strep? Or is this just an elimination procedure to see if her vaginal strep no longer appears?
Any advice would be great! Also, as a bit of history, she's been on numerous antibiotics and it will cure the strep initially, but after a few weeks, it reappears, thus, this is why they cultured her to validate she's a carrier.
Thank you,
Pamela
I have a 9 year old daughter who has recovered from a strep throat infection, and was treated a few days later. That was theis past February 23, after a ski trip with her class. After administering her medicine for 7 of the 10 days, she became very ill again, and was seemingly rejecting the medicine. I took her to the hospital March 9th. I thought her to be dehydrated, but a blood test proved to have normal levels of electolites.
She has been vomiting everyday since then. She's been throwing up bile, and complaining of headaches. She has also lost about 10 pounds or more since the strep infection. She has yet to produce a unrine specimen. (She has been avoiding it.)
I have been giving her Gravol, but I'm afraid of giving her long-term medication. What should I be doing differently? Could you suggest what her condition might be? There something terribly wrong with her, but until the urine test is completed the doctor will not carry out further testing.
Thank you sincerely, a very concerned mother, Christine P. in Ontario, Canada.
Christine P,
I'm so sorry your daughter is having such difficulty. Dr. Moser can't offer a diagnosis or suggest treatments over the internet, but her doctor can.
You should call immediately and request that they see her as soon as possible to arrive at a diagnosis and course of treatment for her.
I hope she feels better soon!
Hi am 20 years old and I got strep for the first time. My doctor put me on azithromycin because I am allergic to pen. I also about 5 months ago got C Diff from taking an antibiotic and I have been very nervous to take antibiotics. So I start my medicine today and had a allergic reaction to it. I was throwing up and had a slight fever of 99. something so my doctor told me to come in. I did and now we are trying Doxycycine. Im just real scraed and I don't know what to do I don't want C Diff again for one and I want a medicine that will work so that I can get rid of Strep Throat. I also suffer from anxiety so I am freaked out that I will get that fever thing or something and die from strep. Can you give me some advice and tell me the chances of dying from strep. Thank you
My daughter has strep throat, was given amoxicillin 400mg. She seems to be doing better, however she has blisters all over her tongue. We have been putting oralgel for the pain. She is not running a fever anymore, and she has been on the med for about 4 days. Is this normal with strep throat.
My 2 year old has alot of white sores on the back of his tounge and throat. What could they be nd should I be alarmed?
My son is 22 and has ADHD..recently we found a new book a doctor wrote about how conditions like ADHD, autism, etc. may be caused by untreated strep in childhood that caused brain inflamation of the amygdala and thalymus. My son virtually lived on amoxicillin and keflex for persistent ear and sinus infections until at the age of 2.5 his doc removed his adenoids and inserted tubes.He still has bad allergies and can only breathe out of one nostril. We are just wondering about the validity of these claims. The book also mentions heavy metal poisoning as a possible threat. What's your opinion? Thanks,
Dear Dr. Moser,
My son is 10 years old and we recently moved to the TN Valley area from Central Florida. Since moving here he has had the flu, Mono and Strep several times. Now, he is testing positive for the Strep Virus, which confuses me. I was under the impression that Strep was a Bactaria Infection, not a Virus. Can you explain the difference? Also, Do you think that our move from Florida to TN has anything to do with him being so sick since we moved here?
I am concerned about my grandson he has strep in his blood . he has taken medication most of the time we have had him living with us for over a year. his hair fell out /he has adhd/ speech problems/ ashma/ learning problems.
My 8-yr-old daughter was just released from The Children's Hospital in Boston,Ma. this past Sunday.Prior to this hospitalization she had been diagnosed & treated for strep throat.At first she was prescribed amoxicillin after 2days she was getting still a higher fever &feeling far worse.We returned to the pediatrician&was then prescribed augmentin,still her health was deteriorating.After about 3days she began complaining about muscle-aches&pains.We returned to the Dr. by this time she had to go in a wheelchair!I am 50yrs-old,my oldest child is 30 I have never seen or even heard of such a thing am I alone in this?Frankly I have never been so scared by an illness..
To those of you with specific questions about strep throat, symptoms or other issues, please post your questions on Dr. Moser's Ear, Nose & Throat board.
Thanks so much!
Dear Dr. Moser,
I have a 3 year old son, who was recently diagnosed with ADHD and had strep throat, URI, and 2 ear infections. He has completed his round of antibiotics (Augmentin). Three days later, I started developing the S&S of strep throat. I don't have insurance, so I just took my left over antibiotics (Amox. 825mg). I had enough to take for 10 days, the same amt. of duration that the doctors prescribed for me to stay on them. When I finished the meds. I began to feel better. I thought I had it under control, but then suddenly I started having severe throat pain. Every time I swallow, it feels like glass and it is very swollen and red/irritated in my mouth. I felt worse after treatment. I realize that when taking antibiotics, you must continue them until the dosage runs out. However, the pills I was taking, was the same amount that the doctors had given me. I just combined two bottles of antibiotics to make one full bottle. They were the same medicine and the same dosage. I was just curious to know whether my S&S could be correlated to something other than strep. It scares me because for one I am a smoker and I know cancer is something I could possibly get. I realize you can't diagnose me for this, but I would like to know any suggestions to my S&S and other related causes of them.
Sincerely,
A.C.
Hi Doctor
I am a 25 year old female diagnosed with acute rheumatic fever. i have been taking pencom as prescribed by my doctor but am now facing muscle pain or muscle spasm in my neck and both my legs. especially my calf muscles hurt a lot. my echo doppler, heart was normal but globulin and ASLO TITRE was high. please suggest. But when i gym all this pain goes away.
hello,
I am 24 years old. I have been getting strep thraot regularly since I was a child. I now get it at least three times a year. My doctor said there are long term kidney risks from having the virus to often. Is this true, and what should I do?
Dear Dr. Moser,
My 3 year old had strep/scarlet fever in April, leading to myself and my wife with strep throat, as well. When we thought we were past this, my 5 year old, my wife and myself again had strep throat 3 weeks later, in May. Now I have just been diagnosed with C-Diff and I am on another antibiotic. I need to know how long and when is "the contagious period?" I can't seem to find this information anywhere. I was out of town, when I was diagnosed, therefore I have not been around my family and since then, I have been on antibiotics for 3 days. Is it safe to go home to my family without infecting everyone? I am still have diaherra and abdominal cramping.
Thank-you!
J.R.
Dear Dr. Moser,
I am a 17 year old male and whenever I swallow i get a pain in the back left side of my throat and my left ear. I am a lifeguard and was wondering if this may be swimmers ear or something else. I was wondering what it was and what can be done
Anonymous,
Try posting your question on Dr. Moser's Ear, Nose & Throat message board.
Thank you.
I have the same problem posted by anonymous on 4/15/2007 where my daughter is on amoxicillin to treat strep throat, and now she has blisters all over her tongue. I was unable to see a response from the doctor to know if this is normal, or if I should call my doctor.
Thanks
Dr. Moser,
When does mononucleosis stop being contagious? I was diognosed with this maybe a week and a half ago but im feeling a hundred percent better. I dont want to take any chances though. Think you could give me some insight?
HELLO!! MY DAUGHTER HAS HAD A HEADACHE FOR 3 DAYS NOW,FEVER UP TO 103 AND AN OFF AND ON TUMMY ACHE. TOOK HER TO THE DR. AND HE DIAGNOSED HER WITH A URINARY TRACT INFECTION. ANTIBIOTICS FOR 3 DAYS NOW ARE NOT WORKING AT ALL!! SHE HAS A DRY COUGH AND COMPLAINS OF HER THROAT HURTING. SHE HAS BEEN EXPOSED TO MONO RECENTLY. THIS IS ALL SO CONFUSING TO ME. I HONESTLY THINK SHE HAS MONO. DO YOU THINK THAT AND EBV BLOOD TEST SHOULD BE ORDERED?
Dear Dr Moser,
i am 14 years old and i have pink eye for a couple of days and i had medicine ofliaxin(?)that when and i have had a sore throat a week and a half now. i don't want to go to the docter. Is there any home Remedies that i could try ?
thank you
Ok, I have been sick for five days. My chest has a feeling of large ammounts of preassure when I try to eat or drink anything, I have blisters on my tounge that hurt, my throat hurts, I have a headache that has not gone away, my whole body hurts, but I do not have a fever. Is is strep throat, or the flu bug or what? I do not get sick very often, so I was just wondering if you can help me out.
Thank you!!!
by taking excessive amount aniboatic for tooth infection, I have stroyed all types of ( good and bad)bacterias, and now developed vaginal alpha strep.(8 months) can not take anymore antiboatic because it is destrying all bacterias. I have discharge, bad odor, tenderness in vaginal area. any information, or advice.
Where do you find the doctor response?
In general, our health professionals post answers to questions on their message boards.
I hope that helps.
45yr old man, last winter was first strep ever dianosed. 10 days ago, felt symptoms coming, tried to ride it out, felt better after four days, fifth day relapse. symptoms became worse, saw doctor, strep, anti-biotics. Four doses, still blood in mucus when blowing nose, sinus pain. Am I still contagious? I really want to hug my 10 month old little girl.
I belive this site sucks u know how on the commercial it says u can find anything well u cant...well anyways i have had red bumps (not herpies) on my toung im am sick im not to sure if it is Strep or Not because the ssymptoms are not the same it is more like a cold that make your tounge swell only a back of throat
To anonymous above:
Here is general information on sore throat. Have you also tried the symptom checker?
I hope those help/
Dear Mr. Moser,
I have a sore throat right now and I've had it for about 3 days. Then I started getting an ear ach and I still haev it. I can actually feel bumps on my throat however they are not white. When I garggled salt water, it burned VERY badly. Would it be O.K for me to take some of my family member's pennisilan until I go to the doctor tommorow or would that be frowned upon?
To Anonymous above: I hope you had the opportunity to visit the doctor today. Dr. Moser cannot answer your questions here, but if you want to post questions to his message board he'll do his best to answer.
Dear Dr. Moser,
I believe I may have the aboved described strep throat. I have an enlarged lymph node on the right side of my throat and it is lumpy and minor puss visable. I have no antibiotics and no health insurance to speak of. Is there any HOME remedies I may try to speed up my healing process?
thank you,
Sincerely,
Marc.m
Dear Dr. Moser,
Thank you for taking the time to read my post.
I am a 28 year old female. On December 20, 2007 I had my tonsils and adnoids removed. My recovery was fantastic. By Christmas I was eating everything and my ENT could not believe how well I had healed.
Since my surgery, I have gotten a sore throat with a fever twice. I was hoping that getting these glands removed my days of calling off work for these symptoms would be over. I sometimes get some ear pain as well. I have to add that I work in a school system grades K-12 as a social worker, which may not help me any :-)
Any suggestions? I am just so incredibly tired of worrying all the time about the health of my throat!
Thanks so much!
Danielle
Dear Dr. Moser,
My daugther is 13 years old and has been diagnosis with mono. My concern is that she cannot sleep. She will get in bed because she is tried and it may take hours to fall asleep. Do you have any suggestions?
Sincerely,
Cheryl G
my 9 year old daughter may have a bladder infection....when she urinates it feels like needles she said. The doctor took tests which results will be back tomorrow but in the meantime, he has put her on SMZ/TMP PED SUSP 200ml 2tsp 2x daily. How does one contract a bladder infection---from wiping the wrong way?
stepmom101
dr moser,
i am a 41 yr old woman who has had several illnesses over the last few years. but recently i have had a issue that has even baffled my own dr. the outer edges of my tongue have turned blue. it is not painful it just looks really strange almost like a dog (chows) tongue would look i have searched everywhere and now i am lost have you ever heard of anything like this or what could it possibly be. anonymous 828
Anonymous above and others:
Please visit Dr. Moser's message board to ask questions about your specific condition.
Thank you.
Dear Dr.
I have a son that is 4 years old and he has had strep 3 times in the past year. About 6 weeks or so ago I noticed at night that his foot was jerking and moving alot. I asked his doctor and they said it sounded like muscle spasms. So after a fews weeks he started to do this more often,even when he would sit on the coach to watch TV his little foot and toes jump and jerk. He woke up one Sunday morning screaming that his foot was jerking really bad and it felt tight. So I rubbed it until it loosened up. I took him back to the doctor and she sent us to a neurologist. He had a sleep test done and it was normal. He had a MRI last Thursday and we go in the morning for the results and a follow up with the neurologist. Last night he woke up crying that his foot was jerking really bad again and was tight. The neurologist had mention that sometimes things like this can happen from strep. Have you hear of anything like this before. I am so worried. And I am not getting much from the doctors. Please help
Sincerely,
A.B.
Im very concern about my throat . My father says i have a lite cold ,and my nose is stuffy and runny and my throat hurts like crazy .Any suggestions .
Hi Doctor,
Tuesday last week, I discovered that I have strep throat. I went and got some amoxicillan and started taking it. It still hurt to swallow after a couple of days and half of my throat began to swell so I went to a clinic to see a doctor. He said since I had already started the antibiotic treatment to continue it and to take motrin to ease the swelling and pain. It is two days later and the swelling has not gone down. The pain has travelled to my left ear and it is excrutiating at times. I've taken Tylenol, aspirin, Motrin and Excedrin and there's no change or relief. I'm still on the antibiotics. Shouldn't I feel better? I don't.
Thanks,
Angela
Dear Dr. Moser,
Can you get strep in any other part of your body besides the throat? My sister, who is 29 years old, got an an infection on her leg and they said that it was strep. She almost lost her leg because of it. I just hadn't heard of getting strep on any other part of the body besides the throat. If it is possible can you tell me anything about it or where I can read about it?
Thank you for your time,
A Cruz
Hi,my tongue and throat hurts when I talk or swallow . It is getting very annoying and troublesome. What is happening and should I go to a doctor?
My daughter is 2 1/2 yrs old. She has had a fever on and off for the last 6 days. 3 days ago she woke up with white bumps on her lips, tongue, and throat. The doctor said it was a viral infection and that there was nothing they could do. She said it would go away in 3-5 days, but she keeps getting worse. I'm starting to get worried about her. She hasn't ate in 4 days and is sleeping all the time. Does anybody know what else could be wrong???!!!
i am 25 years old and i do not have strep, but i do constanly have little off white colored balls that come out of my tonsils..they stink really bad too..but i have no clue to what it could be, its been happening for a few years now...can you help answer what this may be ????
I have the same tonsil ball problem. I have no idea what they are and I would love to get rid of them. I don't have them very often, but I've been having them for years. I have one right now and it's so uncomfortable until it dislodges. Any advice? Thanks!
Those little balls are food particles... they've prob. been there for a while and thats why they smell... :) Remember to brush your teeth for 5 min. a day... three times a day!! and FLOSS!!! :)
My 3 year old daughter has had itching and blistering between her toes of her left foot for a couple of months now. A dermatologist prescribed her a cortisone cream (2%) which worked but now the blistering is coming back. Do you know what this could be? It started when we came back from our trip to the Caribbean. Please help.
Dr. Dr. Moser:
I am a 28 year old female who has had bouts of strep all of my life. About 4 years ago I was told that I am a strep carrier. Last year I had 2 or 3 bouts of strep throat. This year I had a bout in Jan 08 and July 08. My bout in July has been the worst that I can remember, sudden onset on Thursday, fever for 2-3 days, swollen tonsils, painfull to swallow. I started an antibiotic on Tues. on Friday my fever came back. I have been trying to get my family physician to referr me to an ENT doctor to have a tonsillectomy, but she says I have to have 5 documented bouts of strep in 15 months. Is there any information regarding strep in adults, and occurance rate, should I have my tonsils removed?
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