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Revista Da Sociedade Brasileira de... Jul 2014Acute pharyngitis/tonsillitis, which is characterized by inflammation of the posterior pharynx and tonsils, is a common disease. Several viruses and bacteria can cause... (Review)
Review
Acute pharyngitis/tonsillitis, which is characterized by inflammation of the posterior pharynx and tonsils, is a common disease. Several viruses and bacteria can cause acute pharyngitis; however, Streptococcus pyogenes (also known as Lancefield group A β-hemolytic streptococci) is the only agent that requires an etiologic diagnosis and specific treatment. S. pyogenes is of major clinical importance because it can trigger post-infection systemic complications, acute rheumatic fever, and post-streptococcal glomerulonephritis. Symptom onset in streptococcal infection is usually abrupt and includes intense sore throat, fever, chills, malaise, headache, tender enlarged anterior cervical lymph nodes, and pharyngeal or tonsillar exudate. Cough, coryza, conjunctivitis, and diarrhea are uncommon, and their presence suggests a viral cause. A diagnosis of pharyngitis is supported by the patient's history and by the physical examination. Throat culture is the gold standard for diagnosing streptococcus pharyngitis. However, it has been underused in public health services because of its low availability and because of the 1- to 2-day delay in obtaining results. Rapid antigen detection tests have been used to detect S. pyogenes directly from throat swabs within minutes. Clinical scoring systems have been developed to predict the risk of S. pyogenes infection. The most commonly used scoring system is the modified Centor score. Acute S. pyogenes pharyngitis is often a self-limiting disease. Penicillins are the first-choice treatment. For patients with penicillin allergy, cephalosporins can be an acceptable alternative, although primary hypersensitivity to cephalosporins can occur. Another drug option is the macrolides. Future perspectives to prevent streptococcal pharyngitis and post-infection systemic complications include the development of an anti-Streptococcus pyogenes vaccine.
Topics: Acute Disease; Anti-Bacterial Agents; Humans; Pharyngitis; Streptococcal Infections
PubMed: 25229278
DOI: 10.1590/0037-8682-0265-2013 -
Primary Care Dec 1996This article reviews the commonly encountered agents causing acute inflammation of the pharynx and tonsils, with special attention to a practical approach for... (Review)
Review
This article reviews the commonly encountered agents causing acute inflammation of the pharynx and tonsils, with special attention to a practical approach for identifying and dealing with the group A beta-hemolytic streptococcus. Ubiquitous viral agents such as Epstein-Barr virus, rhinovirus, and adenovirus are reviewed. Some agents such as group A beta-hemolytic streptococcus and Epstein-Barr virus are susceptible to treatment. Additionally, unusual infectious agents and noninfectious causes of pharyngitis are enumerated.
Topics: Adolescent; Age Distribution; Algorithms; Anti-Bacterial Agents; Child; Child, Preschool; Decision Trees; Diagnosis, Differential; Humans; Infant; Pharyngitis
PubMed: 8890141
DOI: 10.1016/s0095-4543(05)70359-6 -
Infectious Disease Clinics of North... Jun 2007Acute pharyngitis is one of the most common illnesses for which patients visit primary care physicians. Most cases are of viral origin, and with few exceptions these... (Review)
Review
Acute pharyngitis is one of the most common illnesses for which patients visit primary care physicians. Most cases are of viral origin, and with few exceptions these illnesses are both benign and self-limited. The most important bacterial cause is the beta-hemolytic group A streptococcus. There are other uncommon or rare types of pharyngitis. For some of these treatment is required or available, and some may be life threatening. Among those discussed in this article are diphtheria, gonorrhea, HIV infection, peritonsillar abscess, and epiglottitis.
Topics: Epiglottitis; Humans; Pharyngitis
PubMed: 17561078
DOI: 10.1016/j.idc.2007.03.001 -
Vestnik Otorinolaringologii 2023The relevance of the problem of chronic inflammatory diseases of the pharynx is due to the significant prevalence of this pathology. Among all forms of chronic... (Review)
Review
The relevance of the problem of chronic inflammatory diseases of the pharynx is due to the significant prevalence of this pathology. Among all forms of chronic pharyngitis, the most adverse effect on the quality of life is observed in chronic athrophic pharyngitis. According to the literature, in this category of patients there are no clear criteria for assessing the functional state and morphological picture of the mucous membrane of the posterior pharyngeal wall. Most of the described signs of atrophic pharyngitis are insufficienyly informative, which necessitates further improvement of existing and possible search for new diagnostic methods. Many of the modern methods of treatment do not provide a lasting effect due to the presence of only a local effect on the altered mucous membrane of the posterior pharyngeal wall, without taking into account the changes that are caused by a violation of trophic processes in the tissue, which necessitates the search for new effective methods of treating this disease.The review article outlines modern ideas about the methods of diagnosis and treatment of chronic pharyngitis, presents promising areas in the treatment of patients with atrophic pharyngitis. In foreign countries, the term «chronic tonsillopharyngitis» is most often used. Due to the existing difference in terminology, the predominant part of the material on the problem of chronic pharyngitis is presented by domestic literature sources.
Topics: Humans; Quality of Life; Pharyngitis; Pharynx; Mucous Membrane; Chronic Disease
PubMed: 37450392
DOI: 10.17116/otorino20228803156 -
European Journal of Pediatrics Oct 2014Controversy remains about the need for antibiotic therapy of group A streptococcal (GAS) pharyngitis in high-resource settings. Guidelines on the management of GAS... (Review)
Review
UNLABELLED
Controversy remains about the need for antibiotic therapy of group A streptococcal (GAS) pharyngitis in high-resource settings. Guidelines on the management of GAS pharyngitis differ considerably, especially in children. We performed a literature search on the diagnosis and treatment of GAS pharyngitis in children and compared different guidelines with current epidemiology and the available evidence on management. Some European guidelines only recommend antibiotic treatment in certain high-risk patients, while many other, including all American, still advise antimicrobial treatment for all children with GAS pharyngitis, given the severity and re-emerging incidence of complications. Empirical antimicrobial treatment in children with sore throat and a high clinical suspicion of GAS pharyngitis will still result in significant overtreatment of nonstreptococcal pharyngitis. This is costly and leads to emerging antibiotic resistance. Early differential diagnosis between viral and GAS pharyngitis, by means of a 'rapid antigen detection test' (RADT) and/or a throat culture, is therefore needed if 'pro treatment' guidelines are used.
CONCLUSION
Large scale randomized controlled trials are necessary to assess the value of antibiotics for GAS pharyngitis in high-resource countries, in order to achieve uniform and evidence-based guidelines. The severity and the possibly increasing incidence of complications in school-aged children suggests that testing and treating proven GAS pharyngitis can still be beneficial.
Topics: Anti-Bacterial Agents; Child; Humans; Pharyngitis; Practice Guidelines as Topic; Streptococcal Infections; Streptococcus pyogenes
PubMed: 25113742
DOI: 10.1007/s00431-014-2395-2 -
Pediatric Case Reviews (Print) Oct 2003
Review
Topics: Anti-Bacterial Agents; Bacteriological Techniques; Child, Preschool; Female; Humans; Pharyngitis; Streptococcal Infections; Streptococcus pyogenes
PubMed: 14520082
DOI: 10.1097/01.PCA.0000085283.22184.DF -
Annals of Internal Medicine Sep 2012
Review
Topics: Anti-Bacterial Agents; Humans; Patient Education as Topic; Pharyngitis; Rheumatic Fever; Risk Factors
PubMed: 22944886
DOI: 10.7326/0003-4819-157-5-201209040-01003 -
Enfermedades Infecciosas Y... Dec 1995
Review
Topics: Anti-Bacterial Agents; Carrier State; Clinical Trials as Topic; Drug Resistance, Microbial; Drug Therapy, Combination; Humans; Penicillins; Pharyngitis; Streptococcal Infections; Streptococcus pyogenes; Tonsillitis
PubMed: 8808478
DOI: No ID Found -
Journal of General Internal Medicine Jan 2007Despite numerous controlled trials, clinical practice guidelines and cost-effective analyses, controversy persists regarding the appropriate management strategy for... (Review)
Review
Despite numerous controlled trials, clinical practice guidelines and cost-effective analyses, controversy persists regarding the appropriate management strategy for adult pharyngitis. In this perspective, we explore this controversy by comparing two competing clinical guidelines. Although the guidelines appear to make widely diverging recommendations, we show that the controversy centers on only a small proportion of patients: those presenting with severe pharyngitis. We examine recently published data to illustrate that this seemingly simple problem of strep throat remains a philosophical issue: should we give primacy to relieving acute time-limited symptoms, or should we emphasize the potential societal risk of antibiotic resistance? We accept potentially over treating a minority of adult pharyngitis patients with the most severe presentations to reduce suffering in an approximately equal number of patients who will have false negative test results if the test-and-treat strategy were used.
Topics: Anti-Bacterial Agents; Antigens, Bacterial; Drug Resistance, Bacterial; Humans; Pharyngitis; Practice Guidelines as Topic; Reagent Kits, Diagnostic; Severity of Illness Index
PubMed: 17351852
DOI: 10.1007/s11606-006-0020-4 -
Journal of the South Carolina Medical... Jan 2001
Review
Topics: Adolescent; Adult; Child; Child, Preschool; Diagnosis, Differential; Humans; Infant; Penicillins; Pharyngitis; Streptococcal Infections; Streptococcus pyogenes; Virus Diseases
PubMed: 11227253
DOI: No ID Found