Streptococcal Pharyngitis - Causes, Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Streptococcal pharyngitis

Streptococcal pharyngitis is an inflammation of the mucous membrane of the throat, provoked by group A beta-hemolytic streptococcus.

According to statistics, the disease is most often diagnosed in children aged 5 to 15 years, but the development of inflammation in adults is not excluded. Boys and girls get sick with the same frequency.

Content:

• The causes of streptococcal pharyngitis
• Streptococcal pharyngitis symptoms
• Complications of streptococcal pharyngitis
• Diagnosis of streptococcal pharyngitis
• Treatment of streptococcal pharyngitis

The causes of streptococcal pharyngitis

The causes of streptococcal pharyngitis are reduced to damage to the mucous membrane of the throat with hemolytic streptococcus of group A. Rarely, but acute pharyngitis can also be provoked by streptococci of groups C and G.

The path of transmission of the disease is airborne, from one person to another. The more crowded the team, the higher the risk of infection. In this regard, streptococcal pharyngitis is more often diagnosed in the cold season among people who spend a long time in a closed team.

From time to time, group outbreaks of the disease are recorded due to the consumption of foods inseminated with streptococci.

During the acute phase of the disease, a large number of streptococci are determined in the mucous membrane of the throat. If therapy is not carried out, then they will parasitize in the upper respiratory tract for several more weeks and even months. In this case, the person will no longer experience the symptoms of the disease. Even after a time, streptococci are not completely eliminated from the body, and the person who has recovered becomes a carrier of the infection (provided there is no antibacterial treatment). Although the risk of transmitting the pathogen to other people outside the exacerbation phase is much lower.

Streptococcal pharyngitis symptoms

The symptoms of streptococcal pharyngitis appear after the incubation period ends.

It is 2 to 4 days. The disease is characterized by the following clinical picture:

• Acute onset of inflammation with severe sore throat. The pains tend to get worse when food is swallowed.
• A headache appears, a person experiences general malaise and weakness.
• Body temperature increases, chills are possible. Often the mark on the thermometer exceeds 38.3 degrees.
• In childhood, streptococcal pharyngitis often provokes vomiting, nausea, and abdominal pain.
• The throat is red, swollen, the follicles on its back wall are enlarged.
• The tonsils are hyperemic, edematous, a drainage or point exudate is found on their surface. The color of the mucus varies and can be yellow, white, or gray.
• On the surface of the back wall of the throat, as well as on the tonsils, areas covered with exudate are visible. They can be as large as a pinhead.
• Petechial enanthema on the soft palate may be a symptom of strep throat.
• Regional lymph nodes become enlarged and painful.
• A scarlet fever-like rash may appear on the body.

The disease proceeds quite quickly and within a week its symptoms can be relieved on their own. The body temperature returns to normal on the third or fifth day, after which the symptoms of the respiratory system disappear. The tonsils and lymph nodes are restored the longest. They remain enlarged and painful for several more weeks.

Complications of streptococcal pharyngitis

Complications of streptococcal pharyngitis pose a serious danger to human health.

Purulent complications include:

• Otitis;
• Sinusitis;
• Paratonsillar abscess;
• Periopharyngeal abscess;
• Purulent cervical lymphadenitis;
• Formation of distant purulent foci - arthritis and osteomyelitis.

As for the formation of distant purulent foci, they are very rare in modern medical practice. Although before the discovery of penicillin, such complications developed in 13% of patients.

It is also important to timely recognize the formation of a paratonsillar abscess, since this complication requires surgical intervention. The patient has a sharp increase in sore throat, body temperature rises, the neck area swells.

As for the non-suppurative complications of the disease, among them are:

• Development of acute rheumatic fever, which manifests itself 14-21 days after the relief of symptoms of the disease;
• Glomerulonephritis of post-streptococcal etiology (develops most often on the 8-10th day from the onset of the disease);
• Streptococcal toxic shock (develops at the same time as glomerulonephritis);
• PANDAS syndrome (autoimmune neuropsychiatric syndrome).

Acute rheumatic fever develops most often when the patient has a hereditary predisposition to rheumatic heart lesions, as well as when infected with rheumatogenic streptococcus strains. Its beginning is indicated by a long recovery after an illness, a palpitations, weakness, low-grade body temperature.

Diagnosis of streptococcal pharyngitis

The diagnosis of streptococcal pharyngitis should be carried out in a laboratory setting.

After examining the throat by an otolaryngologist, it is possible to perform the following studies:

• Microbiological examination of a smear taken from the back of the pharynx. Subject to all the rules for the collection and transportation of material, this method is 99% informative.
• Express diagnostics of streptococcal antigen in a smear from the back of the throat. Express testing makes it possible to get results within 4-10 minutes. For the analysis, there is no need for a special equipped laboratory. The sensitivity of the tests is up to 97%.
• Immunoserological diagnostics.

Treatment of streptococcal pharyngitis

The drug of choice for treating streptococcal pharyngitis is penicillin. To do this, the patient is prescribed the intake of Phenoxymethylpenicillin orally for 10 days.

The objectives of antibiotic therapy in this case are:

• Destruction of the causative agent of inflammation;
• Prevention of the development of complications, both purulent and non-purulent;
• Decrease in contagiousness;
• Recovery of the patient.

An alternative drug is Amoxicillin, but when prescribing it, it is important to exclude infectious mononucleosis in order to guarantee to avoid the development of a toxic-allergic reaction.

If penicillin is not possible, or the effect of its use is absent, then the appointment of drugs from the group of cephalosporins (Cefixime, Ceftibuten, Cefuroxime Axetil) or macrolides (Erythromycin, Azithromycin, Clarithromycin, Josamycin, Spiramycin) is indicated.

It should be noted that early initiation of therapy reduces the severity of the course of the disease and significantly reduces the risk of complications. Treatment should be continued for at least 10 days for the complete eradication of the pathogen. If the symptoms of the disease persist for 72 hours after starting the antibiotic, then the drug must be changed.

Symptomatic therapy can speed up clinical recovery. To do this, rinse the throat with antiseptic and antibacterial solutions (Miramistin, Chlorophyllipt, Furacilin, Chlorhexidine, Biclotymol, etc.), irrigate the tonsils and the back of the throat with sprays (Ingalipt, Proposol, Hexoral, etc.).

NSAIDs are prescribed to relieve fever and relieve sore throat. When it comes to children, then Paracetamol or Ibuprofen should be preferred.

It is important to understand that local therapy is not able to replace the systemic administration of antibiotics for streptococcal pharyngitis.

A favorable prognosis for getting rid of streptococcal pharyngitis can be given only if the patient receives timely and adequate treatment.

The author of the article: Lazarev Oleg Vladimirovich | ENT

Education: In 2009, he received a diploma in the specialty "General Medicine" at the Petrozavodsk State University. After completing an internship at the Murmansk Regional Clinical Hospital, he received a diploma in Otorhinolaryngology (2010)