Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Obtaining a specimen is the same whether your doctor will do a throat culture
or rapid test for strep. A cotton swab (similar to a Q-tip) is quickly rubbed
over both tonsils as well as the back wall of the mouth (the posterior pharynx).
It is important to avoid contact with other structures inside the mouth such as
the tongue or cheeks. The
swab is then placed in a specialized container and the rapid test performed.
Many people find that obtaining the swab produces a gagging sensation. However, since the entire swabbing process lasts less than
five seconds this inconvenience is minimal.
What are the limitations of the rapid strep test?
There are several manufactures of rapid strep tests. Each manufacturer has designed
their test to
respond only to the presence of the particular streptococcal bacteria (Group A)
responsible for strep throat. Other bacteria which are less much less likely to
cause pharyngitis are not identified by the rapid strep test.
The test will not
detect viral causes of pharyngitis.
A positive test response occurs when a
reaction between a protein on the surface of strep bacteria and chemicals in the
test materials exists. Either living or dead strep bacteria will produce a
positive reaction.
Most rapid strep tests have a
sensitivity of 95%, meaning that
the test will be positive in 95 of 100 patients who are documented to have strep
throat via throat culture obtained at the same time. Since 5 of 100 patients
with strep throat will be missed using a rapid strep test, all negative swab
specimens should be sent for culture to confirm the absence of strep bacteria.
A
positive culture requires antibiotics.
The rapid strep test has a 98%
specificity. This
means that 98 of 100 positive tests correctly indicate the
presence specifically of Group A streptococcus bacteria; 2 of 100 positive
results are "false positives" - indicative of similarities between various surface
proteins found on strep bacteria and other non-strep bacteria found in the
mouth.
REFERENCE:
Fauci, Anthony S., et al. Harrison's Principles of Internal Medicine. 17th ed. United States: McGraw-Hill Professional, 2008.
Most sore throats are caused by viruses or mechanical causes (such as mouth breathing) and can be treated successfully at home. However, a person should be seen by a health care professional if they have a sore throat that has a rapid onset, and is associated with a fever or tenderness of the front of the neck; a sore throat that causes the person to have difficulty swallowing (not just pain swallowing) or breathing; or if a sore throat lasts for more than a week.
Strep throat is a sore throat caused by a bacterium called streptococcus (strep) that can be treated through antibiotics. Common symptoms of strep throat include pinkeye, runny nose, skin rash, cough, hoarseness, diarrhea and more. Complications of untreated strep throat include middle ear infections, meningitis, pneumonia, rheumatic fever, and more.
An upper respiratory infection is a contagious infection of the structures of the upper respiratory tract, which includes the sinuses, nasal passages, pharynx, and larynx. Common causes of an upper respiratory infection include bacteria and viruses such as rhinoviruses, group A streptococci, influenza, respiratory syncytial, whooping cough, diphtheria, and Epstein-Barre. Examples of symptoms of upper respiratory infection include sneezing, sore throat, cough, fever, and nasal congestion. Treatment of upper respiratory infection are generally with OTC medication and home remedies.
Group A streptococcal infections are caused by group A streptococcus, a bacteria that causes a variety of health problems, including strep throat, impetigo, cellulitis, erysipelas, and scarlet fever. There are more than 10 million group A strep infections each year.
Rheumatic fever is a disease that sometimes occurs after a group A streptococcal infection of the throat. Symptoms and signs include carditis, polyarthritis, Aschoff bodies, rash, Sydenham's chorea, and fever. Treatment for rheumatic fever involves eliminating the bacteria with penicillin, erythromycin, or azithromycin. Further treatment focuses on alleviating the symptoms brought on by the body's immunologic response to the bacteria.
Scarlet fever is an infectious disease caused by the bacteria group A Streptococcus. Symptoms and signs include a rash, sore throat, and fever. Antibiotics are used in the treatment of scarlet fever.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
Teenagers recognize that they are developmentally between child and adult. Teen health prevention includes maintaining a healthy diet, exercising regularly, preventing injuries and screening annually for potential health conditions that could adversely affect teenage health.
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