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[Pharyngeal A-streptococcal infection encountered in the practical work of an internal medicine specialist].
[acute rheumatic fever]
The
problem
of
pharyngeal
infections
caused
by
beta
-
hemolytic
streptococci
of
group
A
(
BHSA
)
remains
a
challenge
for
both
health
providers
and
general
medicine
.
The
present
paper
was
designed
to
provide
the
data
suggesting
the
"
reappearance
"
of
a
highly
virulent
BHSA
infection
and
a
rise
in
the
frequency
of
its
complications
(
such
as
acute
rheumatic
fever
and
toxic
shock
syndrome
)
and
to
substantiate
the
necessity
of
rational
antibacterial
therapy
for
the
management
of
this
pathology
.
The
agents
of
choice
for
the
treatment
of
acute
forms
of
BHSA
(
tonsillitis
and
pharyngitis
)
include
penicillins
(
amoxicillin
,
benzathine-penicillin
,
phenoxymethyl
penicillin
)
and
cephalosporins
of
the
first
generation
(
cephadroxyl
)
as
well
as
macrolids
(
spiramycin
,
azithromycin
,
roxithromycin
,
midecamycin
,
josamycin
)
for
the
patients
who
do
not
tolerate
beta
-lactam
antibiotics
.
Inhibitor-protected
penicillins
(
amoxicillin
,
clavulanate
)
or
cephalosporins
of
the
second
generations
(
cefuroxime-axetil
)
should
be
prescribed
to
the
patients
presenting
with
chronic
recurring
BHSA
characterized
by
the
rather
high
probability
of
colonization
of
the
site
of
infection
by
beta
-lactamase
producing
microorganisms
.
Lincosamine-derived
antibiotics
,
such
as
lincomycin
and
clindamycin
,
are
reserved
for
the
patients
with
acute
and
chronic
BHSA
(
tonsillitis
and
pharyngitis
)
.
Diseases
Validation
Diseases presenting
"acute forms"
symptom
acute rheumatic fever
papillon-lefèvre syndrome
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