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Complications of streptococcal tonsillopharyngitis

INTRODUCTION

Pharyngitis due to infection with group A streptococcus (GAS) is usually a self-limited condition, with symptoms lasting two to five days in untreated patients. When begun within 48 hours of illness, antimicrobial therapy reduced the duration and severity of symptoms by one to two days in double-blind studies and prevented the spread of infection to contacts [1-3]. (See "Treatment and prevention of streptococcal tonsillopharyngitis".)

The other major goal of therapy is to reduce the risk of suppurative and nonsuppurative complications. The potential complications of GAS tonsillopharyngitis will be briefly reviewed here.

NONSUPPURATIVE COMPLICATIONS

The nonsuppurative complications of GAS tonsillopharyngitis include:

  • Acute rheumatic fever
  • Scarlet fever
  • Streptococcal toxic shock syndrome
  • Acute glomerulonephritis
  • PANDAS (pediatric autoimmune neuropsychiatric disorder associated with group A streptococci)

Acute rheumatic fever — Acute rheumatic fever (ARF) is a delayed, nonsuppurative sequela of a pharyngeal infection with GAS. Following the initial pharyngitis, there is a latent period of two to three weeks before the first signs or symptoms of ARF appear [4]. The disease presents with various manifestations that may include arthritis, carditis, chorea, subcutaneous nodules, and erythema marginatum. (See "Clinical manifestations and diagnosis of acute rheumatic fever".)

             

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Literature review current through: Apr 2013. | This topic last updated: May 29, 2012.
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