Acute sore throat- Pharyngitis its causes,symptoms,and treatment

l       Acute sore throat
Pharyngitis


Bacterial infection

l       Viral infection

l       Streptococcus pyogenes – most serious type

l       Scarlet fever

l       Rheumatic fever

l       Glomerulonephritis

l       Streptococcus pyogenes
Group A is virulent

l       Streptolysins  - toxin (hemolysins)

l       Erythrogenic – toxin

l       Toxins can act as superantigens

l       Over stimulate T cells

l       Tumor necrosis factor

Ƅ Bacterial infection:

     Group A beta-hemolytic Streptococcus

     • Most common and important

     • Commonly presents in children aged 5–6

     • Fever, dry sore throat, cervical adenopathy, 

       dysphagia, and odynophagia

     • The tonsils and pharyngeal mucosa are  

       erythematous and may be covered with

       purulent exudate

     • The tongue may also become red ("strawberry 

       tongue")

     • Sequelae: acute rheumatic fever and

       poststreptococcal glomerulonephritis

Treatment of acute phryngitis

l          Penicillin V 250 mg/dose for children and 500mg/dose for adolescents      and adults.

l         Amoxicillin; 750 mg once daily for10 days or 50 mg/kg/day for 6 days divided bid.

l         A single IM injection of benzathine penicillin (600,000U for children < 27 kg; 1,2 million U for larger children and adults.

l         Erythromycin 40 mg/kg  in divided doses for 10 days.

l       Azithromycin offers convenience of once-daily administration and shorter length of therapy.

l       Cephalosporins appear to be as, good as or better than penicillin, perhaps because these drugs are more effective in eradicating streptococcal carriage. Evidence is not sufficient to recommend shorter

courses of cephalosporins for routine therapy at this time