Group A streptococcal pharyngitis and immune-mediated complications: from diagnosis to management.
Group A streptococcal pharyngitis remains the most important bacterial pharyngitis because of its frequency and potential complications. Group A streptococcal pharyngitis is most common in children 5-11 years of age in winter-spring, and a rapid test or culture is necessary for accurate diagnosis. We propose a management strategy for those geographic areas with very low acute rheumatic fever rates, emphasizing selective testing that avoids testing those patients with viral-like features (e.g., rhinorrhea and cough). Acute rheumatic fever is the most important immune-mediated sequela and has become rare in most areas of the USA and Western Europe, most probably due to decreased circulation of highly rheumatogenic group A streptococcal strains.
Shulman
Stanford T
ST
Northwestern University, The Feinberg School of Medicine, Chicago, IL, USA. sshulman@childrensmemorial.org
Tanz
Robert R
RR
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D010612:Pharyngitis / Q000150:complications / Q000175:diagnosis / Q000382:microbiology*; D012213:Rheumatic Fever / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D012541:Scarlet Fever / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D013290:Streptococcal Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D013297:Streptococcus pyogenes