Pharyngitis

Question 1

Presentation of Strep throat

Answer 1

• sore throat w/ fever
• lymphadenopathy
• tonsillar exudates
• absence of cough

Question 2

Cause of pharyngitis

Answer 2

• difficult to differentiate viral & bacterial etiology clinically
• Most common bacterial cause is S. pyogenes

Question 3

Diagnosis of Strep throat

Answer 3

• Rapid antigen-detection test (RADT) & throat culture recommended
• If RADT + –> initiate therapy
• If RADT (-) –> hold therapy pending culture results

Question 4

Complications of Streptococcal Pharyngitis

Answer 4

• Acute Rheumatic Fever

- Poststreptococcal glomerulonephritis (typically resolves in children; ~25% of adults progress to CKD)

Question 5

Treatment of Streptococcal pharyngitis

Answer 5

• treatment w/in 9 days effectively prevents complications
• 1st line tx with PCN or Amoxil (PCN V 250mg QID or 500mg BID) – treat for a duration of 10 days
• alternatives: 1st gen cephalosporins, cleocin, macrolides (if they have a PCN allergy)