Streptococcal Sore Throat Flashcards
Given its rising rates in British Columbia, what bacterium must you consider when diagnosing and treating Group A Strepotococcal sore throat?
Invasive Group A Strep
Group A Strepotoccous is susceptible to which antibiotic classes?
Penicillins, cephalosporins, carbapenems, lincosamides, and some fluroquinolones.
Explain Invasive Group A Streptococcus to a patient.
A very small number of strep infections can cause more problems than your normal strep infections.
Invasive Group A Strep infections tend to happen more often in people who have alcohol use disorder, heart conditions, diabetes, homelessness, injection drug use, skin infections, and wounds.
Most people are colonized with strep, and clear acute infections spontaneously. But why do we treat Group A Streptococcal sore throat?
Reduce risk of peritonsilar abscess, rheumatic fever, poststreptococcal glomerulonephritis, reactive arthritis, sinusitis, meningitis, bacteremia, and necrotizing fasciitis.
What are the JONES criteria?
Joints - migratory arthritis
O - Carditis (shape of heart)
N - nodules
E - erythema marginatum
S - Sydenham’s Chorea
What is the role of a primary care nurse practitioner in treating rheumatic fever?
Referral to the emergency department.
What score can you use to risk stratify management for streptococcal sore throat?
CENTOR score.
What 3 signs are most specific to strep throat?
- Anterior cervical lymphadenopathy
- Palatal petechiae
- Pharyngeal exudate
How does the rapid Group A Streptococcus test work?
Swab of the throat via NAAT; approximately 15 minute turnaround time.
What are the problems with a “rapid strep test?”
Many false positives; will be positive even if patient is colonized.
What is the first-line antibiotic for Group A Streptococcal sore throat?
Penicillin
Does penicillin prevent post-streptococcal glomerulonephritis?
No!
How many days are antibiotics most effective for decreasing the chance of rheumatic fever?
9 days
