“Is it easy to misdiagnose strep throat as tonsillitis? ”
My son had strep throat, and is now being treated for it. However, before he was diagnosed by his pediatrician as having tonsillitis, which I feel is a long shot because you usually have to test for strep throat. We were given a Z-pak at first, but when he wasn't getting better, I took him back and he was diagnosed properly. Is it easy to confuse these conditions?
3 Answers
Tonsillitis and strep are not the same thing nor are they mutually exclusive. Tonsillitis is an infection of the tonsils, pharyngitis an infection of the throat with or without tonsillitis. Strep throat is one of several bacterial infections that can cause tonsillitis or pharyngitis. In addition to bacteria a virus can cause tonsillitis or pharyngitis. The only way to confirm strep is by culture.
The diagnosis can be made on clinical presentation. A culture can taken. Antibiotics can be started. Antibiotic resistance can occur. If culture is negative for strep, may be positive for another treatable bacterium. Treatment then guided by sensitivity results. Most case of tonsillitis/phayngitis are viral which does not respond to antibiotics. Treatment based on experience, presenting signs and symptoms, past history. Adjustments made if initial diagnosis is in error.
In general, if the symptoms are there and the rapid strep is positive, you have a diagnosis of strep. If the rapid strep is negative, then you wait for an overnight culture up to two days to see if that is positive. This approach has a very low level of misdiagnosis. The only scenario would be if the patient is a strep carrier and happens to have a viral tonsillitis, in which case the testing will be positive, but the patient doesn’t really have a strep infection. This would be very difficult to discern.
