Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.
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.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
During the doctor's physical examination, a throat culture might be taken by
touching a soft cotton swab to the throat and tonsil area. Germs from the swab
are smeared onto a special plate and sent to the laboratory for evaluation of
strep or other bacteria. After 24-48 hours, the rapidly-growing strep germs can
be identified if present in the sample. Throat culture is the gold standard in
diagnosing strep throat infection.
A culture for strep throat may not be done as a screening test in an
individual without any symptoms suggestive of strep throat. This is because
bacteria may be present without causing an infection. A person may be a carrier
of the bacteria but not infected.
Rapid strep test
Rapid strep tests (also called the
Rapid Antigen Detection Test or RADT) are
available that can give results in minutes. A sample from the back of the throat or tonsils is taken using a swab similar to the sample for culture. Using a RADT kit, the doctor can determine within a few minutes if strep is the likely cause of sore throat. This test is less precise than throat cultures. Therefore, if the
health care practitioner has a high suspicion for strep throat, both tests (RADT and throat culture) may be performed, and treatment should be started as soon as possible even if the rapid test is negative for strep while waiting for the definitive culture results.
Taking any "self prescribed" antibiotic prior to seeing the doctor should be
avoided because even a single dose of antibiotic can interfere with the culture
results and the health care practitioner's ability to correctly diagnose and treat the infection.
Blood test for strep throat infection
Streptococcus infection can be detected by measuring the antibodies produced
by the body against the bacteria. This is called the Anti-streptolysin O or ASO
titer. This antibody may not be present in the blood for a few weeks after an
infection, and therefore its measurement may not be accurate to detect an active
or acute infection. ASO titers also may not be detectable if the person had been
appropriately treated with antibiotics.
This test may be useful in detecting prior infections and evaluating a person with complications of strep
throat infection such as rheumatic fever or glomerulonephritis (see below).
Strep Throat - Length Symptoms LastedQuestion: How long did the symptoms of your strep throat last? Was there anything in particular that helped with pain/symptom relief?
Infectious mononucleosis is a virus infection in which there is an increase of white blood cells
that are mononuclear (with a single nucleus) "Mono" and "kissing
disease" are popular terms for this very common illness caused by the
Epstein-Barr virus (EBV).
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.
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.
Sleep apnea is defined as a reduction or cessation of breathing during sleep. The three types of sleep apnea are central apnea, obstructive apnea (OSA), and a mixture of central and obstructive apnea. Central sleep apnea is caused by a failure of the brain to activate the muscles of breathing during sleep. OSA is caused by the collapse of the airway during sleep. OSA is diagnosed and evaluated through patient history, physical examination and polysomnography. There are many complications related to obstructive sleep apnea. Treatments are surgical and non-surgical.
Group B strep are bacteria called Streptococcus agalactiae that may sometimes cause infections both in a pregnant woman and her newborn. Symptoms include fever, seizures, heart rate abnormalities, breathing problems, and fussiness. Intravenous antibiotics are used to treat group B strep infections.
It is thought that the tonsils and adenoids assist the body in fighting incoming bacteria and viruses by helping the body form antibodies. This is thought to be important only during the first year of life. Acute tonsillitis, strep throat, mononucleosis (mono), chronic tonsillitis, peritonsillar abscess, and hypertrophic tonsils and adenoids are all common problems involving the tonsils and adenoids. Treatment of tonsillitis and adenoids include antibiotics and other medications depending on the cause. In some cases, a tonsillectomy or adenoidectomy (the removal of the tonsils or adenoids) may be necessary.
Snoring, like all other sounds, is caused by vibrations that cause particles in the air to form sound waves. While we are asleep, turbulent air flow can cause the tissues of the nose and throat to vibrate and give rise to snoring. Any person can snore. Snoring is believed to occur in anywhere from 30% of women to over 45% of men. People who snore can have any body type. In general, as people get older and as they gain weight, snoring will worsen. Snoring can be caused by a number of things, including the sleep position, alcohol, medication, anatomical structure of the mouth and throat, stage of sleep, and mouth breathing.
Erythema nodosum is a skin inflammation that results in reddish, painful, tender lumps most commonly located in the front of the legs below the knees. Erythema nodosum can resolve on its own in 3 to 6 weeks, leaving a bruised area. Treatments include anti-inflammatory medications and cortisone by mouth or injection.
A heart murmur is the sound generated when blood flow within the heart is not smooth. Causes of heart murmurs can be functional, congenital, or caused heart valve conditions. Symptoms of a heart murmur may be none, or may include chest pain, shortness of breath, and arm, leg, and ankle swelling. Treatment of a heart murmur depends on the cause.
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.
Adenovirus infection, particularly Ad14, or the "killer cold virus" has been on the increase in the past two years. Symptoms range from those experienced with colds, sore throat, bronchitis, pneumonia, diarrhea, pinkeye, fever, bladder infection, and neurological conditions. Diagnosis and treatment options need to be discussed with your physician.
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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