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.

Tonsillopharyngitis%20-%20acute Signs and Symptoms

Definition

  • Tonsillopharyngitis is the acute inflammation of the pharynx, tonsils, or both

Etiology

  • Caused by gram-positive cocci known as S pyogenes
  • This organism exhibits beta-hemolysis on blood agar plates
  • They belong to group A Lancefield classification system for beta-hemolytic strep infection
Mode of Transmission
  • Spreads through person-to-person contact, usually through saliva or nasal secretions from an infected person
  • The primary reservoir of group A streptococcus are the humans
  • The disease is easily transmitted in the following places:
    • Schools
    • Day care centers
    • Military training facilities
  • Transmission via food is rare and if transmission happens, it is most of the time due to improper handling of food
  • Pets and the use of household items such as plates and toys cannot transmit the disease or bacteria

Signs and Symptoms

Clinical Features Suggestive of Group A Beta-Hemolytic Streptococci Pharyngitis

  • The incubation period is approximately 2-7 days

Most Classic Symptoms:

  • Tonsillar swelling/exudates
  • Tender anterior cervical lymphadenopathy
  • Absence of cough
  • Fever >38°C

Other Features of Group A Beta-Hemolytic Streptococci Pharyngitis

  • History of exposure
  • Sudden onset of sore throat
  • Pain on swallowing
  • Petechiae on soft palate (“doughnut” lesions)
  • Scarlet fever rash
  • Beefy red, swollen uvula
  • Tonsillopharyngeal inflammation & erythema with or without exudates
  • Headache
  • Nausea & vomiting (N/V)
  • Abdominal pain
  • Malodorous breath

Clinical Features Suggestive of a Viral Etiology:

  • Absence of fever
  • Conjunctivitis
  • Coryza
  • Cough
  • Diarrhea
  • Anterior stomatitis
  • Hoarseness
  • Discrete ulcerative lesions
  • Rhinorrhea
  • Viral exanthem and/or enanthem

Risk Factors

  • Commonly infects children aged 5-15 years old & rare in <3 years old
  • Parents of school-aged children and other adults who are in close contact with the infected individual
  • Crowded places like day care centers, schools and military barracks
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Infectious Diseases - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Pearl Toh, 6 days ago
The combination therapy comprising carfilzomib, cyclophosphamide and dexamethasone (KCd) is effective, with a tolerable safety profile, in an Asian cohort with high-risk multiple myeloma (MM) — thus providing a more economical alternative as a potential upfront regimen in resource-limited settings, according to leading experts during a myeloma education webinar.
Pearl Toh, 21 Sep 2020
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
Yesterday
Weight suppression appears to result in future onset of eating disorders characterized by dietary restriction or compensatory weight control behaviours, suggesting weight-suppressed women represent an at-risk group that may benefit from selective prevention programmes, a study has found.
2 days ago
Nocturia is a risk factor for mortality, according to the results of the Nagahama Study, which boasts of a low incidence of missing data and high representation of the general population.