Streptococcal Pharyngitis

Question 1

What organism causes streptococcal pharyngitis?

Answer 1

Streptococcus pyogenes (beta haemolytic strep)

Question 2

In what age group is streptococcal pharyngitis most prevalent?

Answer 2

5-15 years

Less immunity, immunologically naive

Question 3

How is streptococcal pharyngitis spread?

Answer 3

Direct person to person spread- droplets

*association with over crowding

Question 4

Is some with streptococcal pharyngitis is untreated what type of specific antibody will they develop?

Answer 4

M protein specific

Question 5

What are the clinical features of streptococcal pharyngitis?

Answer 5

• Abrupt onset of sore throat
• malaise
• fever
• headache
• lymphoid hyperplasia
• tonsillopharyngeal exudate

Question 6

If a throat swab is taken of someone with streptococcal pharyngitis, what type of bacteria are you expecting to find?

Answer 6

Group A strep

Question 7

What is a complication of streptococcal pharyngitis?

Answer 7

Scarlet fever

Suppurative (pus forming, v rare)

Acute rheumatic fever

Acute post-streptococcal glomerulonephritis

Question 8

What causes scarlet fever?

Answer 8

Due to infection with streptococcal pyrogenic exotoxin strain of S.pyogenes

Question 9

What are the features of scarlet fever?

Answer 9

Very similar to streptococcal pharyngitis in symptoms

but there is a rash - feels like sand paper (blanching rash)

High fever

Question 10

Give some examples of suppurative complications that can occur with streptococcal pharyngitis (4)

Answer 10

• peritonsillar cellulits (abscess)
• retropharyngeal abscess
• mastoiditis, sinusitis, otitis media
• meningitis, brain abscess
• if there is pus formation it is possible to put pressure on structures close to the tonsils. This can have adverse effects

Question 11

What is acute rheumatic fever?

Answer 11

Inflammation of heart, joints, CNS

Question 12

What is post- streptococcal glomerulonephritis?

Answer 12

Acute inflammation of renal glomerulus

Question 13

Name some microbial causes for a sore and red throat and tonsils?

Answer 13

Viral - adenovirus, EBV
Bacterial - group A streptococci, S.pneumoniae, H. Influenza
Fungal - candida

Question 14

For someone who has a sore throat and is not requiring antibiotics, what treatment would you recommend?

Answer 14

Bed rest and fluids

Question 15

How would you explain to someone why you are not administering antibiotics?

Answer 15

1. If it is most likely a viral infection and antibiotics wont be able to help that
2. Antibiotics would only reduce illness time by a few hours