I missed this back in December – The rediscovery of pharyngitis in adolescents and Arcanobacterium hemolyticum
Yesterday I was seeing a new admission in the ER and ran into a colleague admitting a sore throat patient. You can imagine that I rarely miss the opportunity to examine and take a history from sore throat patients. Yesterday's patient has a small tonsillar abscess.
Medpedshosp talks about my Annals article and adds a nice description of Arcanebacterium pharyngitis. He writes well, and the article is well worth reading.
There is a new trend in pharyngitis that has taken hold amongst emergency physicians – the use of steroids to provide symptom relief. Two recent articles address this issue:
- Corticosteroids for pain relief in sore throat: systematic review and meta-analysis
- Steroids as Adjuvant Therapy for Acute Pharyngitis in Ambulatory Patients: A Systematic Review
I was asked to write a comment on the second article – scroll to the end of the article to find the link. These articles do not include enough patients to really know about complications due to steroids masking worsening symptoms. Maybe I am a curmudgeon, but I worry about potential downsides for minor upside with steroids.
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Years ago I had a son with a very persistent ear problem. It was ‘glue ear’ plus.
The Pediatrician wanted to try a round of Prednisoine. He’d told me he’d read that it would work to help stop the swelling and let all the thick fluid in that area drain away.
If memory serves me the son didn’t have a raging infection at the time, but most likely was still on some kind of antibiotic. When you have a kid like that antibiotics tend to take up permanent residence in your fridge.
We tried it and it worked.
Great post. I riffed on it over at Movin’ Meat. I have to say that I agree that caution is needed with this therapy, gratifying though it is.
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