What Causes Frequent Strep Infections and How Can I Stop Them?
At 25 years old, I’m of average height and slightly above the average weight. I don’t smoke and don’t take any medication. Currently, I’m struggling with a strep throat infection. It began last night around 7 PM when I noticed a sharp pain in my throat. I reached out to my mom, suggesting we might need to adjust our plans, as I suspected strep. I visited urgent care this morning, and unfortunately, my suspicion was confirmed. Just two weeks earlier, on Memorial Day, I had dealt with this exact issue. I carefully completed my antibiotic course as directed, thoroughly cleaned my bedding, disinfected all the surfaces I typically touch, and even switched to a new toothbrush every time I brushed my teeth. I made sure to drink tea and rinse my mouth with saltwater, adhering to all recommended precautions, yet the infection still returned. This pattern isn’t unfamiliar to me; a similar incident occurred last year when I completed a round of antibiotics only to have the infection recur just a week later. Typically, I experience strep throat about once a year, but during particularly rough years, it can spike to two or three times. I’ve reached a point where I can tell if I’m dealing with strep by the end of the first day after my throat starts hurting, even before getting tested. I’m puzzled by the frequency of these infections and the persistence of reinfection. It’s incredibly disheartening. While I am aware that having my tonsils removed could be an option, I’ve also heard that it might increase my susceptibility to other illnesses such as colds, which I definitely want to avoid since I already tend to fall ill every couple of months. My immune system feels quite compromised. What other strategies can I employ to minimize my risk of further strep infections? Or is the surgical option of removing my tonsils my only alternative?
Answers (1)
6/16/2025, 5:10:44 PM
OpenHealth AI
Experiencing frequent strep throat infections can be frustrating and concerning, especially since you've taken diligent care of your health. This pattern can arise from several factors, including the behavior of the bacteria, your immune response, or even environmental conditions. Let’s break down the situation and explore actionable strategies to help you minimize the recurrence of these infections.
Understanding Your Situation
Streptococcal throat infections are caused by Group A Streptococcus bacteria. You’ve noted that you experienced a strep throat infection twice in quick succession, which might suggest:
- Incomplete eradication of bacteria: Sometimes, the bacteria can linger, leading to reinfection.
- Environmental factors: Surfaces can harbor bacteria, and exposure to infected individuals can increase your risk.
- Immune system concerns: A compromised immune response may make you more susceptible to infections.
Regarding tonsillectomy (removal of tonsils), it can be a solution for those with recurrent strep throat, but it's not without risks, such as potential increased susceptibility to other illnesses. It's essential to weigh the pros and cons in consultation with a healthcare provider.
Actionable Strategies
Here are several steps you can take to minimize your risk of further strep infections:
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Continue good hygiene: You’re already doing a great job with this, but consistency is key. Keep washing your hands regularly, especially after being in public spaces or around others who are ill.
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Stay hydrated and maintain a balanced diet: Proper hydration and nutrition bolster your immune system. Focus on foods rich in vitamins C and D, zinc, and antioxidants.
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Manage stress: Stress can weaken the immune system. Incorporate stress-reduction techniques such as yoga, meditation, or exercise into your daily routine.
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Avoid close contact with sick individuals: Whenever possible, steer clear of people who show symptoms of a strep throat or other infections.
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Explore natural remedies: Some find benefits in immune-boosting supplements, such as echinacea or elderberry. Discuss these with a healthcare provider to ensure they’re appropriate for you.
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Consider regular throat swab testing: If you suspect a recurrent infection, having a swab test at the onset of symptoms can be useful for timely treatment before it sets in fully.
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Consult a specialist: If you continue to have recurrent infections despite these measures, it may be worthwhile to see an ENT (Ear, Nose, and Throat) specialist who can provide more targeted evaluations, including discussions around tonsillectomy.
Next Steps
- Implement the hygiene, nutrition, and stress management strategies outlined above.
- Monitor your symptoms closely, taking note of any patterns in your infections.
- Consider scheduling a follow-up with a healthcare provider or an ENT specialist to discuss the recurrence of infections and evaluate whether further action, such as a tonsillectomy, is warranted.
Staying proactive about your health is essential, and it's understandable to feel disheartened by these recurrent infections. Remember to acknowledge your efforts in maintaining your health, and reach out for additional support as needed. Things can improve!
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7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options
# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - **Portocaval shunt size: 9.9 mm** (blood bypassing the liver into the inferior vena cava) - **Arteriovenous shunt size: 4.4 mm** - **Portal vein size: 6.1 mm** (patent) - **Three nodular cystic lesions** located in the perivascular area, with largest measuring 11.6×20.7 mm, enhancing during the venous phase - Liver features a heterogeneous architecture, exhibiting irregular enhancement - Gallbladder appears elongated and slightly enlarged - Other abdominal organs exhibit normal findings **RADIOLOGIST’S ASSESSMENT:** "Congenital portosystemic shunt indicative of Abernethy malformation; less likely arteriovenous malformation (AVM); cannot dismiss the possibility of localized liver lesions." **ADVICE:** Seek consultations with an abdominal and vascular surgeon. ### Blood Tests (August 1, 2025): **Complete Blood Count:** - WBC: 10.44 × 10⁹/L (normal range) - **RBC: 2.1 × 10¹²/L** (LOW - indicating severe anemia) - **Hemoglobin: 69 g/L** (CRITICALLY LOW; normal is 117-166) - Platelets: 403 × 10⁹/L (elevated) **Biochemistry Analysis:** - Urea: 1.80 mmol/L (normal) - Creatinine: 33.4 μmol/L (normal) - **ALT: >1000 IU/mL** (EXTREMELY HIGH - severe liver dysfunction) --- ## FOLLOW-UP IMAGING (December 16, 2025 - 5.5 Months Old) ### Liver Ultrasound: **RESULTS:** - Right lobe: 64 mm, left lobe: 43 mm - Liver capsule appears irregular and vague - **Parenchyma: heterogeneous, showing 7 hypo-isoechoic nodules** (sizes range from 11.5×10.7 mm to 17.6×15.4 mm) - Capsule features uneven contours - Blood flow noted during Doppler examination - No dilation in intrahepatic bile ducts - **Portal vein: 3.9 mm** (decreased from 6.1 mm - indicating improvement) - Common bile duct: 1.4 mm - Gallbladder: measures 43.7×9.2 mm (pear-shaped, wall thickness 2.0 mm, homogeneous, free of stones) **ULTRASOUND ASSESSMENT:** "Presence of liver volumetric formations (specifically liver hemangiomas)." --- ## LATEST MSCT (February 6, 2026 - 7 Months Old) ### MSCT with 3-Phase Contrast: **FINDINGS:** - Liver remains normal in size, but shows heterogeneous structure with uneven contrast enhancement - **Portocaval shunt: 9.9 mm** (no change, continues to drain directly into the inferior vena cava avoiding liver acinus) - **Arteriovenous shunt: 4.4 mm** (no alteration) - **Three nodular cystic lesions** in perivascular space, maximum size 11.6×20.7 mm, enhancing in the venous phase - **Portal vein: 6.1 mm** (noted during porto-venous phase) - Arteries show no filling abnormalities - Intrahepatic bile ducts remain non-dilated - Gallbladder is elongated and slightly bigger, free from stones - Pancreas: normal - Spleen: measures 66.9×38.5 mm (not enlarged), splenic vein is 3.6 mm - Kidneys: normal placements and structure - No excess fluid detected in the abdominal cavity - No visible changes in lymph nodes **MSCT ANALYSIS:** "Congenital portosystemic shunt indicative of Abernethy malformation, unlikely to be AVM, presence of focal liver lesions cannot be ruled out." **RECOMMENDATION:** Engage with an abdominal and vascular surgeon. --- ## RECENT BLOOD WORK (December 2025 - January 2026) ### Complete Blood Count (January 19, 2026): - WBC: 5.8 × 10⁹/L (SHOWS IMPROVEMENT) - **RBC: 2.93 × 10¹²/L** (IMPROVED but still low) - **Hemoglobin: 72 g/L** (SHOWS IMPROVEMENT but still low) - Platelets: 223 × 10⁹/L (BACK TO NORMAL) - Neutrophils: 30.0% - Lymphocytes: 64.8% - Monocytes: 4.6% ### Biochemistry (January 28, 2026): - Total protein level: 67 g/L (slightly deficient) - Creatinine: 20.7 μmol/L - **Total Bilirubin: 242 μmol/L** (STILL HIGH - unchanged) - **Direct Bilirubin: 142 μmol/L** (VERY HIGH) - **ALT: 50 IU/mL** (DRASTICALLY LOWER from >1000!) --- ## OVERVIEW OF PROGRESS OVER 6 MONTHS | Parameter | August 2025 | January 2026 | Change | |------------------|-------------|---------------|--------------------------| | **Hemoglobin** | 69 g/L | 72 g/L | ↗ Slight improvement | | **RBC** | 2.1 | 2.93 | ↗ Improved | | **ALT** | >1000 | 50 | ✓✓ MAJOR IMPROVEMENT | | **Bilirubin** | 245 | 242 | → Unchanged (still elevated) | | **Portal vein** | 6.1 mm | 3.9 mm (US) | ↗ Decreased | | **Platelets** | 403 | 223 | ↘ Normalized | | **Shunt size** | 9.9 mm | 9.9 mm | → No Change | --- ## CURRENT SITUATION (February 2026 - 7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? 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