Ver el código de «Streptococcal pharyngitis»

==Background==
[[File:Gray1014.png|thumb|Anatomy of the posterior pharynx.]]
*Peak in 5-15yr old<ref name=Review09>Choby BA (March 2009). "Diagnosis and treatment of streptococcal pharyngitis". Am Fam Physician 79 (5): 383–90. PMID 19275067.</ref>
*Rare in <2yr of age<ref name=Review09>Choby BA (March 2009). "Diagnosis and treatment of streptococcal pharyngitis". Am Fam Physician 79 (5): 383–90. PMID 19275067.</ref>
*Accounts for only 15-30% of [[pharyngitis]]<ref name=Review09>Choby BA (March 2009). "Diagnosis and treatment of streptococcal pharyngitis". Am Fam Physician 79 (5): 383–90. PMID 19275067.</ref>
*Caused by [[ S. pyogenes]] (Group A strep)<ref name=Review09>Choby BA (March 2009). "Diagnosis and treatment of streptococcal pharyngitis". Am Fam Physician 79 (5): 383–90. PMID 19275067.</ref>
*Peak season is late winter / early spring<ref name=Review09>Choby BA (March 2009). "Diagnosis and treatment of streptococcal pharyngitis". Am Fam Physician 79 (5): 383–90. PMID 19275067.</ref>
*Transmission is respiratory secretions<ref name=Review09>Choby BA (March 2009). "Diagnosis and treatment of streptococcal pharyngitis". Am Fam Physician 79 (5): 383–90. PMID 19275067.</ref>
*Incubation period is 24-72 hours<ref name=Review09>Choby BA (March 2009). "Diagnosis and treatment of streptococcal pharyngitis". Am Fam Physician 79 (5): 383–90. PMID 19275067.</ref>
*Antibiotics shorten symptoms by 16 hours<ref name=Review09>Choby BA (March 2009). "Diagnosis and treatment of streptococcal pharyngitis". Am Fam Physician 79 (5): 383–90. PMID 19275067.</ref>

==Clinical Features==
[[File:Pos strep.jpg|thumb|culture positive strep pharyngitis with typical tonsillar exudate]]
*[[Sore throat]]
*Painful swallowing
*[[Fever]]
*[[Nausea and vomiting]]
*Tonsillar exudate
*Palatal [[petechiae]]

''Should NOT have a rash; if have scarlatiniform rash consider [[scarlet fever]]''

{{Modified Centor Criteria}}

==Differential Diagnosis==
*[[Acute rheumatic fever]]
*[[Scarlet fever]]
*Suppurative complications 
**[[Peritonsillar abscess]]
**[[Mastoiditis]]

{{Sore throat DDX}}

{{DDX oral rashes and lesions}}

==Evaluation==
*Per a 2016 Cochrane Review of rapid strep tests in children, tests on average had a specificity of 95% and sensitivity of 86%, regardless of type of rapid strep test used (enzyme immunoassays or optical immunoassays).<ref>Cohen JF, Bertille N, Cohen R, Chalumeau M. What is the performance of rapid tests for the diagnosis of strep throat in children?. Cochrane Review. Published 4 July 2016. https://www.cochrane.org/CD010502/ARI_what-performance-rapid-tests-diagnosis-strep-throat-children</ref>

{{RADT algorithm}}

==Management==
===[[Antibiotics]]===
{{Streptococcal Pharyngitis Antibiotics}}

===[[Steroids]]===
*Consider single dose of [[dexamethasone]] 0.6mg/kg PO (Max = 10mg)<ref>[[EBQ:TOAST Trial]]</ref>

==Disposition==
*Discharge

==Complications==
*[[Acute rheumatic fever]]
*[[Scarlet fever]]
*[[Toxic shock syndrome]]
*[[Post-streptococcal glomerular nephritis]]
*[[Pediatric autoimmune neuropsychiatric disorder associated with group A streptococci (PANDAS)|PANDAS syndrome]]
*[[Peritonsillar abscess]]
*Cervical [[lymphadenitis]]
*[[Mastoiditis]]

==See Also==
*[[Sore Throat]]

==References==
<references/>

[[Category:Pediatrics]]
[[Category:ENT]]
[[Category:ID]]