Sore Throat Flashcards
Some pearls on the presentation of Strep Throat
The signs and symptoms of GAS and non-streptococcal pharyngitis overlap so much that accurate diagnosis based on a clinical exam alone is quite difficult. Acute GAS pharyngitis primarily affects children 5-15 years of age in the winter and early spring. It presents with a sudden onset of sore throat, painful swallowing, and fever. There is often headache, abdominal pain, and nausea or vomiting. There may be other findings such as palate petechiae, swollen uvula, or scarlatiniform rash, but none of these findings are truly specific for GAS pharyngitis.
A throat swab for GAS rapid antigen testing and/or culture should be performed except when overt viral features (such as a runny nose, cough, hoarseness, or oral ulcers) are present. Testing in children less than 3 years of age is not typically indicated, because the incidence of GAS and acute rheumatic fever are quite rare in this age group. Selected children 27KG) or amoxicillin (50mg/kg PO q24 hours x 10 days Max 1000mg/day). For penicillin-allergic patients, a first generation cephalosporin- cephalexin, clindamycin, or clarithromycin for a 10-day course is used. Likewise, azithromycin can be prescribed for five days, improving compliance, although macrolide resistance can be found in 5-15 percent of streptococcal strains
