Streptococcal Pharyngitis

Streptococcal pharyngitis is inflammation and infection of the throat and palatine tonsils caused by bacteria called Streptococcus pyogenes, also known as Group A Streptococcus. It is one of the most common causes of bacterial sore throat, particularly in children aged 5 to 15 years.

Most sore throats are caused by viruses, which do not respond to antibiotics. Therefore, the key part of treatment is distinguishing streptococcal infection from viral infection, done by means of a throat culture or swab test.

Symptoms

Common symptoms include rapid onset of sore throat, difficulty swallowing, fever, and visible swelling of the tonsils. Sometimes white patches appear on the tonsils and a grey-brown coating develops on the tongue. Cough, runny nose, and red eyes generally indicate viral infection rather than streptococcal pharyngitis.

Diagnosis

Diagnosis is made by swabbing the throat, followed by rapid antigen testing to detect bacterial antigens or by throat culture. Cultures take longer but are more accurate. Doctors may also use clinical scoring systems to assess the likelihood of infection before testing.

Treatment and transmission

Standard treatment is antibiotics of the penicillin or amoxicillin class; patients allergic to penicillin receive alternatives. Antibiotics shorten the duration of symptoms, reduce transmission, and prevent complications. The infection spreads through respiratory droplets released by coughing or sneezing, making homes and schools sites of rapid transmission.

Possible serious complications

Without treatment, the infection can cause acute complications such as abscess of the tonsils, and delayed complications including rheumatic fever, which can damage the heart, and post-streptococcal glomerulonephritis, which affects the kidneys. In low-income regions, rheumatic fever and resulting heart disease remain a significant public health burden.