Monday, May 08, 2006

Strep Throat and Vaginal Candidiasis

More than a week ago, I diagnosed myself with Strep sore throat (streptococcal pharyngitis). It started with painful swallowing, right-sided cervical (neck) lymph node tenderness, and, when viewed on the mirror, right tonsil was inflamed (red) with some tiny pinpoint exudates (white spots). I was also starting to feel muscle pains on my thighs (the kind of soreness when you have sudden physical effort exerted). The next day it got worse, and the exudates were more and larger. The right one was also getting affected. Body aches and joints pains spread quite fast, involving headache. I knew it was another bout of strep.


Of course, even without the benfits of lab, it was easy to treat -- penicillin type of medications, first in line is amoxicillin. Can be intramuscular penicillin (one shot) or other penicillin-type antibiotics like cefalexin.


But, since I am not a licensed physician here in the US, I have to seek consultation with one to get the Rx, which I did, and the throat swab confirmed my diagnosis. I spent $60 for the cosultation, inclusive of the $15 lab test, which were unnecessary but inevitable expenses for me when I only needed a valid prescription (that is what a miss in my life in PI. Then the cefalexin (Duracef) was $70 for the 10-day course of treatment (it was cheaper when I had the penicillin shot at $50 At Reddington Fairview General Hospital when I went there during emergency hours. The bill then was higher because of the "emergency" hours. (It is cheaper to go to a clinic at an appointment. Our family clinic, Skowhegan Family Medicine, could immediately accomodate us usually, if we call during office hours on weekdays. Hence, when I had my symptoms on Thursday night that progressed the next day, I did not waste time. I called them rather than go to ER during weekend/night. Strep is, anyway, cured only with antibiotics.


Now, I have finished the course of cefalexin, and I have a new problem, as a result of altered vaginal flora (the normal bacteria residing in the vaginal mucosa), the environment within my vaginal canal was also altered (mainly pH), and it was an opportunity for a yeast infection (moniliasis). Symptoms: pruritus (itchiness) at the vulva and perineum (private parts) plus white cottage-cheese like discharge that is adherent (you can't go wrong with that -- once you have these symptoms, and knowing the predisposing factors, you may not need a laboratory done. Treatment: Monistat or Clotrimazole are very good first line of treatment.


Of course, the best way to prevent is practising good feminine hygiene, but that was not my problem. I was predisposed to it because of my prior intake of the wide-spectrum antibiotic cefalexin.


More info on vaginal candidiasis here.


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