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.
There is not an easy system to decide who should be tested for strep throat.
However, there are certain predictors that make the possibility of strep
tonsillopharyngitis likely. These include:
Children and adolescents between the ages of five and 15
Illness occurring in the late fall, winter, or early spring months
Clinical evidence of acute pharyngitis:
redness and swelling in throat, white discharge on the tonsils
Some clinical studies suggest that if all of these points are present, then
the likelihood of strep throat may be up to 85%. The doctor may decide if
testing is necessary based on these or other clinical factors.
How is strep infection treated?
Because of potential significant complications (described below), if strep
throat is detected, it must be treated adequately with antibiotics. It is
important to take the full course of antibiotics as prescribed and not to stop
the medication when symptoms resolve. Prematurely discontinuing antibiotics can
result in the infection being inadequately treated, with potentially adverse
consequences or relapse of the infection.
Antibiotics
Streptococcus is highly responsive to penicillin and the cephalosporin
antibiotics. Penicillin has shown good effectiveness, and it is reliable and
cheap.
Oral penicillin V
(Pen-Vee-K, Veetids) is the preferred oral form of penicillin for strep throat.
The usual dose is 250 milligrams three times a day or 500 milligrams twice a
day. A full 10 day course must be completed even though patients usually feel
better only after two to three days.
Injectable penicillin G (Bicillin) is also very effective and may be used in individuals
who may not reliably take 10 days of antibiotics orally. The drug may last in
the body for up to 21 days and can therefore adequately treat the infection.
Other penicillin derivatives such as amoxicillin (Amoxil),
amoxicillin-clavulanate (Augmentin), cloxacillin
(Cloxapen, Tegopen), and dicloxacillin (Dynapen) are all
adequate treatments for strep. They may be even slightly more effective than
penicillin because of better absorption and greater potency.
Cephalosporin antibiotics are also a very effective in treating group A
streptococcus. In some studies, they were found to be better than penicillin,
and there is some suggestion that they may be the first choice antibiotic for
this infection. For now, they remain a very good choice in patients with mild
penicillin allergies.
Some examples of cephalosporin antibiotics used to treat strep throat are:
Other options are macrolides, such as
erythromycin (E-Mycin, Eryc, Ery-Tab,
PCE, Pediazole, Ilosone), azithromycin (Zithromax), and clarithromycin
(Biaxin). These antibiotics have shown similar to superior effectiveness
compared to penicillin for the treatment of group A streptococcus. Erythromycin
is thought to be the optimum choice for people with severe
penicillin allergy.
The current recommendations still list penicillin as the first choice for the
treatment of group A streptococcus. Erythromycin is recommended as the first
choice in penicillin-allergic individuals. First generation cephalosporins such
as cephalexin and cefadroxil, are alternatives to erythromycin.
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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