Dear Dr. Peg,
If you are feeling sick, is there a way to determine if you have a bacterial versus viral infection without going to the clinic? For example, can you determine this by taking your temperature, observing swollen glands, having green snot or coughing up stuff?
The short answer is no. There is no surefire way to tell without going to the clinic. However, if I were a betting woman, I'd put money on a virus, and I'd win big. Viruses cause the vast majority of respiratory infections. That includes most colds, sinus infections, bronchitis and most ear and eye infections. It includes most cases of fever, swollen glands, green snot and coughing up stuff.
Viruses and bacteria are two kinds of infectious organisms. The practical difference between them comes in with the question of antibiotics. Antibiotics kill bacteria. Antibiotics do not kill viruses. Your body kills viruses for free. No clinic charge, no waiting in lines, no pharmacy charge. All it needs is some rest and time.
Now, everyone has a story of going to the doctor for a respiratory infection and leaving with a prescription for antibiotics. We hear it all the time. "Last time, I had the same symptoms, and I got antibiotics, and it cleared right up." Naturally, the patient wants the same treatment this time. The truth is, he or she probably would have gotten better anyway. The timing of the antibiotics with the patient's improvement convinced the patient that the antibiotics were responsible for his or her recovery.
Unfortunately, sometimes doctors prescribe antibiotics when they aren't needed, "just in case." This causes a couple of problems. For one, it sets up a patient like the one above to expect antibiotics for viral infections. That creates busy clinics and dependent patients who think they can't get over a simple cold without professional help.
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On a wider scale, when we carpet-bomb bacteria with antibiotics, most bacteria will get killed. But a few will develop resistance to the antibiotic and survive. The survivors can multiply and create a whole new group of tougher germs. Now science has to create a stronger antibiotic to kill these super-bugs. There have been some very scary germs created by this exact scenario.
I trust I've made my point about viruses. But remember, I said most respiratory infections are caused by viruses. That means some are caused by bacteria. For example, the bacterium streptococcus pyogenes causes a throat infection commonly called strep throat. That definitely requires an antibiotic to kill the bacteria and prevent dangerous consequences of the infection. Most kinds of pneumonia require an antibiotic, as do some ear and eye infections, and, rarely, sinus infections.
If you're looking for criteria, I suggest the following:
If you get a respiratory infection with the usual sore throat, congestion and cough, give your body a few days to work on it. Take over-the-counter remedies if you like. Drink lots of liquids to keep the mucous flowing. Try a sinus rinse. But if you have a high fever, a really bad sore throat that lasts for more than a few days, trouble breathing or symptoms that last longer than a week, come in to the clinic for evaluation. Err on the side of caution, and come in anytime if you have doubts. Call (505) 277-7965 for advice or for an appointment.
Peggy Spencer, M.D., has been a UNM Student Health physician for 17 years and a Daily Lobo contributing columnist for three years. She is co-author of the book 50 Ways to Leave Your 40s, released in March. E-mail your questions to her directly at Pspencer@unm.edu. All questions will be considered, and all questioners will remain anonymous. This column has general health information only and cannot replace a visit to a health care provider.
