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Streptococcal acute pharyngitis.
[acute rheumatic fever]
Acute
pharyngitis
/
tonsillitis
,
which
is
characterized
by
inflammation
of
the
posterior
pharynx
and
tonsils
,
is
a
common
disease
.
Several
viruses
and
bacteria
can
cause
acute
pharyngitis
;
however
,
Streptococcus
pyogenes
(
also
known
as
Lancefield
group
A
β-
hemolytic
streptococci
)
is
the
only
agent
that
requires
an
etiologic
diagnosis
and
specific
treatment
.
S
.
pyogenes
is
of
major
clinical
importance
because
it
can
trigger
post-infection
systemic
complications
,
acute
rheumatic
fever
,
and
post-streptococcal
glomerulonephritis
.
Symptom
onset
in
streptococcal
infection
is
usually
abrupt
and
includes
intense
sore
throat
,
fever
,
chills
,
malaise
,
headache
,
tender
enlarged
anterior
cervical
lymph
nodes
,
and
pharyngeal
or
tonsillar
exudate
.
Cough
,
coryza
,
conjunctivitis
,
and
diarrhea
are
uncommon
,
and
their
presence
suggests
a
viral
cause
.
A
diagnosis
of
pharyngitis
is
supported
by
the
patient
's
history
and
by
the
physical
examination
.
Throat
culture
is
the
gold
standard
for
diagnosing
streptococcus
pharyngitis
.
However
,
it
has
been
underused
in
public
health
services
because
of
its
low
availability
and
because
of
the
1
-
to
2
-
day
delay
in
obtaining
results
.
Rapid
antigen
detection
tests
have
been
used
to
detect
S
.
pyogenes
directly
from
throat
swabs
within
minutes
.
Clinical
scoring
systems
have
been
developed
to
predict
the
risk
of
S
.
pyogenes
infection
.
The
most
commonly
used
scoring
system
is
the
modified
Centor
score
.
Acute
S
.
pyogenes
pharyngitis
is
often
a
self-limiting
disease
.
Penicillins
are
the
first
-choice
treatment
.
For
patients
with
penicillin
allergy
,
cephalosporins
can
be
an
acceptable
alternative
,
although
primary
hypersensitivity
to
cephalosporins
can
occur
.
Another
drug
option
is
the
macrolides
.
Future
perspectives
to
prevent
streptococcal
pharyngitis
and
post-infection
systemic
complications
include
the
development
of
an
anti-
Streptococcus
pyogenes
vaccine
.
Diseases
Validation
Diseases presenting
"common disease"
symptom
acute rheumatic fever
epidermolysis bullosa simplex
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