DR. HOOK- Suspect strep? Most sore throats are something else

The life insurance business doesn't make sense to me. Why would a company base earnings on the hope that none of its clients bite the dust? It's so Russian Roulette. My college buddy works for a major insurance company, so I decided to apply for term life insurance through him. Little did I know that the application process was going to be as hard as Frodo's trek to destroy the Ring.  

   I first filled out a health questionnaire longer than the last Harry Potter book. Then someone called me on the phone to review my questionnaire, which took 30 minutes. Well, that wasn't enough: my college buddy had to call me again to review everything to make sure I wasn't lying, having a senior moment while filling out the questionnaire, or high. Lastly, I had to schedule an "examiner" to come to my office and ask the same health questions– twice for two different forms.

It took four weeks to have an examiner come to my office because the first examiner was a no-show. When I called her to find out where she was, she said in a fake Bonny "Total Eclipse of the Heart" Tyler voice, "Oh, I'm not coming because I have staph infection. Can't you hear it?" Staph throat? Get your illness right, Ms. Examiner! It's strep throat! (And she was going to examine me? I could only imagine where she would have stuck her thermometer.)

   Group A Streptococcus is commonly known as strep throat, and if untreated, it can cause rheumatic fever–leading to heart and/or kidney disease. The classic four signs of strep are 1) fever, 2) enlarged lymph nodes in the front of the neck, 3) swollen tonsil with discharge, 4) no cough. Because strep throat isn't a viral cold, there shouldn't be a stuffy, runny nose, cough, or congested ears.  

   But as with everything, nothing is perfect– even Martha Stewart. If four of the four signs are present, 50-70 percent of the time it's strep throat. If only two of the four signs are present, then 80 percent of the time there's no strep throat.  

   There are plenty of other bacteria that can cause an acute sore throat (pharyngitis): Group C & G streptococcus are not on the "A" list (so would Kathy Griffin get a D strep with her show, Life on the D List?)  This fact might be hard to swallow, but STDs like gonorrhea and Chlamydia can cause pharyngitis. Mycoplasma, the atypical bacteria known for walking pneumonia, and diphtheriae can cause pharyngitis (though most tetanus booster shots have protection against diphtheriae).  

   Treating strep throat with an antibiotic is important to prevent abscess formation, spreading it to others (incubation period is about seven days, as many moms and dads well know), to make the victim feel better (since it makes your throat feel like Bruce Springsteen screaming for hours on stage), and also to prevent rheumatic fever.

   A rose is a rose is a rose... but most pharyngitis is usually not strep throat. Fifty percent of pharyngitis cases are viral: the flu, common cold, mono, acute HIV, and even herpes are to blame. So an antibiotic for bacteria will be ineffective for viral pharyngitis. (Have you ever gone to the doctor, and the antibiotic didn't get rid of your pharyngitis? Probably was viral.)  

   Drooling, not being able to swallow, and neck swelling can be bad signs of something worse than pharyngitis, such as an abscess or a swollen epiglottis.  

   Warm salt water gargles, Listerine, and herbal tea with licorice root (yuck, I hate licorice) are nice things to soothe the ailing throat.  

   Well, good news. I got my life insurance and even got a discount because I was in the 90th percentile for longevity. So I didn't need to be examined by the person with "staph throat" after all! I'm glad I wasn't exposed to her imaginary disease, because I wouldn't have been caught dead strep naked in front of her.

Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.