Streptobacillus moniliformis

also widely used, and can give results within three minutes.

Treatment A positive strep test requires antibiotic treatment to prevent complications. Antibiotics (penicillin) given seven to nine days after the illness starts will prevent RHEUMATIC FEVER. Benzathine penicillin G is usually injected, since this type of penicillin stays in the body for 10 days. Oral penicillin V must be taken four times a day for 10 days; some studies suggest that oral penicillin may lead to more relapses. Those who are allergic to penicillin may take erythromycin. Oral cephalexin and other new drugs are also effective but more expensive.

These bacteria are often resistant to tetracycline or sulfonamide.

High fevers may be treated with acetaminophen. Easy-to-swallow foods or cold food (ice cream, frozen juice bars, warm soup, mashed bananas, puddings, gelatins, noodles, soft drinks) are good choices.

Gargling with warm salt water and warm tea with honey and lemon are effective pain reducers. It is not important if the patient doesn't want to eat, but fluids are critical.

Complications The risk of severe complications is the primary concern with strep throat, and the reason why it is so important to be properly diagnosed and treated. One of the most serious complications is rheumatic fever, a disease that affects up to 3 percent of those with untreated strep infection. Rheumatic fever can lead to rheumatic heart disease.

Kidney inflammation (acute glomerulonephritis) is another possible complication of strep throat, which can appear from 10 days to 6 weeks after the throat infection. The bacteria do not directly infect the kidneys; instead, the body's immune system response can damage the kidney's filtering mechanism. Warning signs of impending kidney problems include swelling of hands, face, and feet; dark or bloody urine; headaches; vision problems; and decreased urinary output. Children usu-

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