Acute Pharyngitis Flashcards
Most important agents causing pharyngitis
1) Viruses 2) GABHS
Major virulence factor for GABHS
M protein
Virulence factor of GABHS that facilitates resistance to phagocytosis by PMNs
M protein
Prominent sore throat and fever in the absence of cough
Acute pharyngitis
Pharynx is red, tonsils enlarged and clasically covered with a yellow blood-tinged exudate
Strep pharyngitis
Petechiae or doughnut lesion on the soft palate and posterior pharynx
Strep pharyngitis
Bacterial vs viral pharyngitis: Rapid onset
Bacterial
Bacterial vs viral pharyngitis: Gradual onset
Viral
Bacterial vs viral pharyngitis: Rhinorrhea, cough, diarrhea
Viral
Bacterial vs viral pharyngitis: Concurrent conjunctivitis and fever
Viral, specifically adenovirus
Bacterial vs viral pharyngitis: Small grayish vesicles and punched-out ulcers in the posterior pharynx
Viral, specifically Coxsackie herpangina
Bacterial vs viral pharyngitis: Small yellowish-white nodules in the posterior phraynx
Viral, specifically Coxsackie acute lymphonodular pharyngitis
Septic thrombophlebitis of the IJV with septic pulmonary emboli, producing hypoxia and pulmonary infiltrates
Lemierre syndrome
Lemierre syndrome is a serious complication of
F. necrophorum pharyngitis
Gold standard for diagnosing strep pharyngitis
Throat culture; an IMPERFECT gold standard
T/F Rapid test to detect group A strep antigen is highly specific, so if a rapid test is positive, throat culture to diagnose strep pharyngitis is unnecessary and appropriate treatment is indicated
T
T/F Most untreated episodes of strep pharyngitis resolve uneventfully in a few days
T
T/F Early antibiotic therapy for strep pharyngitis hastens clinical recovery
T, by 12-24hrs
Primary benefit of treatment of strep pharyngitis
Prevention of ARF
Early antibiotic therapy for strep pharyngitis successfully prevents ARF if treatment is instituted within
9 days of illness
T/F GABHS remains universally susceptible to Penicillin
T
Treatment regimen most effective for eradication of streptococcal carriage
Clindamycin
If compliance with antibiotic treatment for strep pharyngitis has been poor, ___ is suggested
IM benzathine penicillin
Lowers incidence of pharyngitis for 1-2 yrs among children with recurrent culture-positive GABHS pharyngitis that has been severe and frequent
Tonsillectomy
Frequent pharyngitis is defined as
> 7 episodes in a year, or >5 in EACH of the preceding 2 years
T/F Viral respiratory infections can predispose to bacterial middle ear infections
T
