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If, then, it can  represent itself as just a rhinitis, how often and WHO do you test?  It seems to me we're looking awfully hard for something that doesn't need to be treated.

-----Original Message-----
>From: Kevin Powell <[log in to unmask]>
>Sent: May 28, 2010 7:04 PM
>To: [log in to unmask]
>Subject: Re: Rapid Strep Test < 2 years old
>
>Along with the Red Book information cited by others, may I add 3 articles
>from Clinical Pediatrics, July/August 1999
>
>http://cpj.sagepub.com/cgi/content/abstract/38/6/357 states that:
>The incidence of both true infection and carrier state gradually increased
>with age. Nevertheless, true streptococcal pharyngitis was found even in
>patients younger than 1 year and its percentage related to carriers did not
>increase with age and was ?50% in all age groups up to 4 years. The authors
>conclude that true GABHS pharyngitis may present in the first year of life.
>
>and
>
>http://cpj.sagepub.com/cgi/reprint/38/6/361
>is entitled
>Group A Streptococcal Pharyngotonsillitis in Children Less Than 2 Years of
>Age More Common Than is Thought
>
>So to answer Fred's questions, based on these articles, Group A strep in
>toddlers is a real URI. It is not as easily recognized because the tonsils
>early on don't look like those of older kids -- often just purulent
>rhinitis. It is not just a carrier state. The idea that toddlers can't get
>strep is outdated by over 10 years. In my clinic, I haven't tested for it
>often or routinely, but I treat it when found.
>
>Kevin Powell MD PhD FAAP
>SSM Cardinal Glennon Children's Medical Center
>Associate Professor of Pediatrics
>Saint Louis University
>
>
>
>
>For more information, send mail to [log in to unmask] with the message: info PED-EM-L
>The URL for the PED-EM-L Web Page is:
>                 http://listserv.brown.edu/ped-em-l.html


Fergus Thornton
read my blog @ http://docdownunder.wordpress.com

For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
                 http://listserv.brown.edu/ped-em-l.html

For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
                 http://listserv.brown.edu/ped-em-l.html