tonsillopharyngitis%20-%20acute
TONSILLOPHARYNGITIS - ACUTE
Patients with group A beta-hemolytic streptococcal pharyngitis have classic symptoms of tonsillar swelling/exudates, tender anterior cervical lymphadenopathy, with no cough but with fever of >38ºC.
Clinical features suggestive of a viral etiology are conjunctivitis, absence of fever, coryza, cough, diarrhea, anterior stomatitis, hoarseness, discrete ulcerative lesions, rhinorrhea and viral exanthem and/or enanthem.
Antibiotics will not be needed for every patient that presents with sore throat but it should not be withheld if the clinical condition is severe or group A beta-hemolytic streptococcus is suspected.
  1. Bisno AL, Gerber MA, Gwaltney JM, et al. Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Clin Infect Dis. 2002 Jul;35(2):113-125. http://cid.oxfordjournals.org/content/35/2/113.full.pdf. PMID: 12087516
  2. Snow V, Mottur-Pilson C, Cooper RJ, et al; American Academy of Family Physicians; American College of Physicians-American Society of Internal Medicine; Centers for Disease Control. Principles of appropriate antibiotic use for acute pharyngitis in adults. Ann Intern Med. 2002 Mar;134(6):506-508. PMID: 11255529
  3. Fauci AS, Braunwald E, Isselbacher KJ, et al/Fauci AS, Braunwald E, Isselbacher KJ, et al. Harrison's Principles of Internal Medicine. 14th ed: McGraw-Hill; 1998
  4. Fauci AS, Braunwald E, Isselbacher KJ, et al. Harrison's Principles of Internal Medicine. 14th ed: McGraw-Hill; 1998
  5. MedWormhttp://www.medworm.com/rss/index.php/Pediatrics/33/http://www.medworm.com/rss/medicalfeeds/specialities/Pediatrics.xml
  6. MedWormhttp://www.medworm.com/rss/index.php/Respiratory-Medicine/40/http://www.medworm.com/rss/medicalfeeds/specialities/Respiratory-Medicine.xml
  7. Academy of Medicine of Malaysia. Clinical practice guidelines on pneumonia and respiratory tract infections in children. http://www.acadmed.org.my. Oct 2001. Accessed 16 Jul 2010.
  8. Institute for Clinical Systems Improvement (ICSI). Acute pharyngitis. Bloomington, MN: Institute for Clinical Systems Improvement (ICSI). https://www.icsi.org/. May 2005
  9. Michigan Quality Improvement Consortium. Acute pharyngitis in children. Southfield, MI: Michigan Quality Improvement Consortium. http://mqic.org/. Jan 2007
  10. Ministry of Health, National Medical Research Council, Chapter of Physicians Academy of Medicine Singapore. Clinical Practice Guidelines: use of antibiotics in adults. MOH (Singapore). http://www.moh.gov.sg/. Apr 2000.
  11. Alberta Clinical Practice Guideline Working Group. Guideline for the diagnosis and treatment of acute pharyngitis. http://www.pemdatabase.org/. Nov 2001.
  12. Institute for Clinical Systems Improvement (ICSI). Health care guide: acute pharyngitis. Dec 2001
  13. Ministry of Health Malaysia. Management of sore throat. Clinical practice guidelines. http://www.moh.gov.my/. Apr 2003
  14. Institute for Clinical Systems Improvement (ICSI). Health care guideline: acute pharyngitis. http://www.icsi.org. Dec 2001
  15. Alberta Clinical Practice Guidelines Working Group. Guideline for the diagnosis and management of acute pharyngitis. Toward Optimized Practice. http://www.topalbertadoctors.org/. Jan 2008. Accessed 19 Mar 2014.
  16. Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012 Nov;55(10):1279-1282. doi: 10.1093/cid/cis847. Accessed 19 Mar 2014. PMID: 23091044
  17. Batra K, Safaya A, Nair D, Capoor M. Sore throat - a review of presentation and etiology. Indian J Otolaryngol Head Neck Surg. 2004 Jan;56(1):14-19. doi: 10.1007/BF02968764. PMID: 23120018
  18. Centers for Disease Control and Prevention. Group A streptococcal (GAS) disease: pharyngitis (strep throat). CDC. https://www.cdc.gov/. Sep 2016.
  19. Centers for Disease Control and Prevention. Group A streptococcal (GAS) disease: strep throat. CDC. https://www.cdc.gov/. Sep 2016.
  20. National Institute for Health and Care Excellence. Sore throat (acute): antimicrobial prescribing. NICE. http://www.nice.org.uk/. Jan 2018.
  21. Pichichero ME. Treatment and prevention of streptococcal tonsillopharyngitis. UptoDate. http://www.uptodate.com/. Oct 2018.
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