The Doctors Will See You Now

What’s the difference between a cold and a bacterial sinus infection?

The “common cold” is actually comprised of hundreds of viruses. Symptoms include sneezing, nasal congestion, malaise, headache, sore throat, and cough.  Although cold symptoms can make patients feel quite ill -- accounting for 40% of sick days taken by American adults each year -- colds are “self-limiting,” meaning they get better with time (an average of 7-10 days) without any specific intervention.  And because they’re caused by a virus, they don’t respond to antibiotic treatment, because antibiotics only kill bacteria.

Sinus infections are usually viral as well.  In fact, 85% of sinusitis cases resolve on their own.  However, if a patient with a viral sinus infection stays congested for more than 10 days, the mucus can become colonized with bacteria and lead to a bacterial sinusitis that requires antibiotic treatment.  Signs of a bacterial sinus infection include symptoms > 10 days, sinus pain, purulent nasal discharge and a fever.

What’s the most accurate way to test for genital herpes?

Up until a few years ago, we used to routinely screen for Herpes Simplex Virus (the virus that causes genital herpes) with a blood test, but that’s no longer recommended because the test was shown to be inaccurate in about 50% of cases, and it didn’t differentiate between the Herpes Simplex virus that causes cold sores, and the Herpes Simplex virus that causes genital herpes.

So we no longer screen asymptomatic patients for herpes.  However, if a patient has a genital rash, we can swab the fluid inside the blister-like sores that herpes causes and send off that fluid for a viral culture, which is much more accurate than the blood test.  

(And, of course, we recommend practicing safe sex to minimize the risk of contracting genital herpes, or any other sexually transmitted infection!)

If I have a cut that may need stitches, how soon do I need to be seen?

The short answer is: as soon as possible!  The faster you come in, the faster we can irrigate your wound and close it up to prevent infection, and to control bleeding.  

The longer answer to your question is that ideally, wounds should be sutured within 12 hours.  Wounds that are sutured after 12 hours have higher rates of complication, including infection.  

When you come to us for wound care, we can also make sure you’re up to date on your tetanus vaccine (which should be within 5 years of an open wound).  

How do I know if I need an antibiotic for my cough?

We see a lot of patients who come to us with coughs. Many of them say they have been diagnosed with bronchitis in the past and given an antibiotic (like the 5-day Zpack) for their symptoms.  

Also, a lot of patients request antibiotics when they’re coughing up yellow or green phlegm, thinking that yellow or green phlegm indicates a bacterial infection, while clear or white phlegm indicates a viral infection.  Believe it or not, researchers have done multiple studies looking at whether sputum color correlates with a bacterial or viral infection.  And they determined that sputum color is not an indicator of the type of infection that’s causing a cough.

It turns out that 95% of coughs, whether dry or productive, are caused by a virus -- which means that an antibiotic is unnecessary. Prescribing antibiotics for viral infections can lead to antibiotic resistance, and to unnecessary side effects.

If you have a cough, there are a lot of other medicines we can prescribe for you to help you feel better faster, so please schedule an appointment so we can evaluate you!   But keep in mind that if you don’t have chronic lung disease, a fever, abnormal breath sounds or a positive chest x-ray, an antibiotic is usually not needed.

What’s the difference between a strain, a sprain, and a fracture?

A lot of people get confused about these terms, so we’re glad you asked!  

  1. A strain happens when a muscle is overstretched.  While any muscle in your body can be strained, the most common sites are the neck, back, shoulder and hamstring.
  2. A sprain happens when a ligament (a band of fibrous tissue that connects one bone to another) is overstretched.  The ankle and the wrist are the most common locations for sprains.  
  3. A fracture is a break in a bone.  Some patients ask us what the difference is between a fractured bone and a broken bone.  “Fracture” and “break” mean the same thing, so the terms are actually interchangeable (though technically, “fracture” is the formal medical term).

Golden Gate Urgent Care

If you have an injury or illness, we have a team of excellent providers, same-day appointments, and six clinics to choose from.  Go to www.goldengateurgentcare.com to schedule an appointment, or just walk in!

If you have a question you’d like the doctors to address in the next round of “The Doctor(s) Will See You Now,” send it to us on Facebook, Twitter or Instagram!

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