Pharyngitis Caused by Streptococcus Pyogenes

Summary

The objective of the contribution is to summarize information on the recommended procedures for diagnosis and therapy of pharyngitis caused by Streptococcus pyogenes. Therefore, Czech recommended procedures as well as those of several European countries and the United States of America were examined. Pharyngitis caused by Streptococcus pyogenes is an acute infectious disease of oropharynx and/or nasopharynx. In most cases the disease results in spontaneous recovery. Immunogenic consequences of streptococcal infection are redoubtable, but presently rare complications in the Czech Republic

Typical symptoms of acute pharyngitis include sore throat and increased temperature. Diseases with such symptoms are caused by viral infection in most cases, only in about 5-30% by bacteria including S. pyogenes. The bacteria can produce the erthrogenic toxic in rare cases, causing that the described symptoms are accompanied by exanthema.

The diagnosis of pharyngitis caused by S. pyogenes is confirmed by cultivation or demonstration of the antigen. The control cultivation examination is not performed in patients who underwent antibiotic therapy and in inapparent carriers.

Patients with pharyngitis caused by S. pyogenes are treated with antibiotics, which mitigate subjective symptoms, limit spreading of the infection, prevent local complications and also present primary prevention of immunogenic consequences. Oral penicillin for 10 days is the treatment of choice, which in patients allergic to penicillin is a macrolide antibiotic. Patients with scarlatina are treated with injection penicillin. The antibiotic therapy is not indicated in carriers without symptoms. In relapsing acute pharyngitis caused by S. pyogenes it is not recommended to use long-term antibiotic therapy. A repeated acute inflammation is again treated by penicillin.

In the Czech Republic there are no binding epidemiological measures for pharyngitis caused by S. pyogenes, only scarlatina is the subject of acknowledgement (reporting).

Key words:
pharyngitis, Streptococcus pyogenes, recommended procedures, antibiotics, immunogenic consequences, acute inflammation.