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Any explanation on all the positive rapid strep tests in the below age
group? Is it all GAS respiratory tract infection?



Fred



-----Original Message-----
From: Chamberlain, Jim [mailto:[log in to unmask]]
Sent: Thursday, May 27, 2010 7:04 PM
To: Fred Wu; [log in to unmask]
Subject: RE: Rapid Strep Test < 2 years old



From the Red Book (AAP Committee on Infectious Diseases), 2009:



"Toddlers (1 through 3 years of age) with GAS respiratory tract

infection initially can have serous rhinitis and then develop a

protracted illness with moderate fever, irritability, and anorexia

(streptococcal fever). The classic presentation of streptococcal upper

respiratory tract infection as acute pharyngitis is uncommon in children

younger than 3 years of age. Rheumatic fever also is rare in children

younger than 3 years of age."



The rest of the chapter is silent on treatment in this age group.



It has been my practice not to test or treat in children < 3 y.o. unless

there is difficulty in eradicating Strep from a family, but this is

usually the domain of the PCP, not me.







James Chamberlain, MD

Division Chief, Emergency Medicine

Children's National Medical Center

111 Michigan Avenue, NW

Washington, DC 20010



202.476.3253 (O)

202.476.3573 (F)

202.476.5433 (Emergency Access)





-----Original Message-----

From: Pediatric Emergency Medicine Discussion List

[mailto:[log in to unmask]] On Behalf Of Fred Wu

Sent: Thursday, May 27, 2010 9:04 PM

To: [log in to unmask]

Subject: Rapid Strep Test < 2 years old



Hello everyone,



Our PA/NPs are swabbing a lot of kids < 1-2 years old with the rapid

strep test and they're coming back positive. One of our PAs is claiming

that he's had 5-10 positives in the past 2 months. It seems pretty

unusual for strep pharyngitis to be present in a child < 2 years old

(from what I recall).



Any thoughts? Is the disease profile changing? They're all carriers?



Thanks,

Fred



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