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Complications of Streptococcal Pharyngitis

  • Pharyngitis caused by A streptococcus (GAS) is usually a self-limited condition; symptoms in untreated patients typically last two to five days. Antimicrobial therapy reduces the duration and severity of symptoms byone to two days and prevents spread of infection (Pichichero,2017)

  • Potential complications of GAS Pharyngitis

    • Nonsuppurative complication

      • Acute rheumatic fever (ARF)

        • The incidence of acute rheumatic fever (ARF) in the United States is ≤ 2 cases per 100,000 school-aged children (Beaudoin at al., 2015)

      • Acute glomerulonephritis

        • The incidence of clinically detectable glomerulonephritis in children infected during an epidemic is about 5 to 10 percent with pharyngitis (Pichichero, 2017)

      • Scarlet Fever

        • The incidence of scarlet fever is estimated to be 0.3 cases per 1000 per year (Pichichero, 2017)

      • Poststreptococcal arthritis (PSRA)

      • Streptoccal toxic shock syndrome

    • Suppurative complications

      • Peritonsillar abscess

        • The incidence of pediatric retropharyngeal abscess ranged from .1 case/10,000 in 2000 to .22/10,000 (Van Brusselen et al., 2014)

      • Mastoiditis

      • Otitis Media

        • GAS accounts for less than 5 percent of all cases of acute otitis media (Pinchero, 2017)

      • Sinusitis

      • Necrotizing fascitis

      • Strptococcal bacteremia

      • Meningitis

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.