Dr. Phil Moehler

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November 15, 2012
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MOHLER: Mom, I have a sore throat!

Can a mom tell if it's Strep? Can a physician sort out the signs and symptoms of a sore throat and make a definitive diagnosis? The answers are "no" and "mostly no."

For more than 15 years, physicians have tried to apply various scoring systems to sort out the presence of Strep based on tender lymph nodes in the front of the neck, pus in the throat, and the presence or absence of cough and fever. The bottom line is that these calculators miss the Strep diagnosis frequently and over-diagnosis it in other situations.

There are two occasions where I have some confidence in sorting out Strep versus viral sore throats without a culture or rapid Strep test. First, the patient with a sore throat, cough, runny nose, mouth ulcers, and hoarseness is very unlikely to have Strep and testing is not needed.

The second situation is where one child in a family has signs and symptoms of Strep, has the diagnosis confirmed, only to have his sister or dad quickly develop a very similar illness. It is extremely likely the second (and sometimes the third and fourth) family member has Strep as well and treatment can be started without testing.

Most persistent sore throats deserve a test. Some physician's offices provide testing without an office visit. Another option is the Mesa County Health Department, where patients may walk in for a test Mondays and Wednesdays, 8 a.m.-5 p.m., Tuesdays 9 a.m.-6 p.m., Thursdays 8 a.m.-2 p.m. and Fridays 8 a.m.-noon. The fee is $20 and the result of the culture is available in 24 hours.

Dr. Mohler has practiced family medicine in Grand Junction for 38 years. He has a particular interest in pharmaceutical education. Phil works part-time for both Primary Care Partners and Rocky Mountain Health Plans.

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The Post Independent Updated Nov 15, 2012 12:23PM Published Nov 15, 2012 12:22PM Copyright 2012 The Post Independent. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.