title: Severe acute pharyngitis caused by group C streptococcus.
abstract: BACKGROUND
  Adult group C beta-hemolytic streptococcal pharyngitis has a prevalence of approximately 5%. It can present with a broad spectrum of severity.
  
  
  METHODS
  We report a 30-year-old woman who presented with severe Group C streptococcal pharyngitis.
  
  
  CONCLUSIONS
  She presented with a 9-day history of progressive symptoms, including fever, sore throat, neck swelling, and recent onset of hoarseness. In the 9 days before the emergency room (ER) presentation, the patient had visited the ER twice complaining of a sore throat. At both visits, the physicians performed rapid antigen strep testing. Each time her test was negative and the physicians recommended symptomatic therapy. Her symptoms continued to worsen leading to her repeat presentation. At this time she had severe pharyngitis with markedly enlarged tonsils. Neck CT excluded peritonsillar abscess. Rapid strep testing was again negative, but her throat culture grew group C beta-hemolytic streptococcus.
  
  
  CONCLUSIONS
  This presentation illustrates the importance of a systematic approach to evaluating patients with negative rapid strep tests and worsening pharyngitis.
authors.affiliation: Department of Family Practice, University of Alabama, Huntsville Regional Medical Campus, Huntsville, AL, USA.
authors.forename: Mobin
authors.initials: M
authors.lastname: Shah
authors.forename: Robert M
authors.initials: RM
authors.lastname: Centor
authors.forename: May
authors.initials: M
authors.lastname: Jennings
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D006801:Humans; D010612:Pharyngitis / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology*; D013290:Streptococcal Infections / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology*; D013291:Streptococcus / Q000145:classification* / Q000302:isolation & purification