Pharyngitis And Infective Endocarditis Flashcards
Pharyngitis - pathogens
*Strep pyogenes (gabhs)
Viruses (most common) - “cold” viruses, flu
Non-strep pharyngitis (rare)
Pharyngitis - diagnosis
Clinical presentation +/-
Throat culture (takes longer, more sensitive)
Rapid Antigen Detection Testing (RADT)
Pharyngitis - clinical presentation
5-15 yrs old
“Centor criteria” - Sudden onset sore throat
fever, non-productive cough, + nodes,
Inflamed pharynx and tonsil w/patchy discrete exudate
Winter-early spring
Viral:
Cough, hoarseness
Diarrhea
Pink eye
Pharyngitis - DOC (initial)
- PCN VK (oral) or amoxicillin (most use this b/c less freq and easier to tolerate)
- Cefadroxil, cefixime, Cefdinir
If PCN allergic:
macrolide (Azithro)
If can’t tolerate PO:
IM: PCN Benzathine
Pharyngitis - DOC (recurrent)
oral: Clindamycin or AMX-CLA
IM: Benzathine
another name for strep pyogenes
GABHS
mono/epsteinn barr vs strep throat
splenomegaly
posterior chain cervical adenopathy
treatment goal for strep throat
prevent rheumatic heart disease and peritonsilar abcess
Who needs prophylaxis for endocarditis (dental procedures)?
Very specific - prosthetic valve, history infective endocarditis, congenital heart defects
manipulation of gingival tissue
Dental prophylaxis
AMX (30-60 minute before)
PCN allergic:
Macrolide (azithromycin, clarithromycin)
Macrolides - Why is azithromycin generally preferred over erythromycin?
easier dosing, less GI effects
If a pt is PCN allergic, what is GENERALLY the next class?
Macrolide
Why is AMX often given when PCN is the drug of choice?
Easier dosing (better compliance)
If you treat for strep throat with PCN and pt gets a diffuse rash, what should you consider?
It may have been mono and PCN not indicated.
