Acute pharyngitis/tonsillitis is defined as inflammation of the posterior pharynx and tonsils. Most cases of acute pharyngitis resolve without antibiotic treatment. Many viruses and bacteria can cause acute pharyngitis; however, Streptococcus pyogenes (also known as Lancefield group A, β-hemolytic streptococci) is the most common bacterial cause of pharyngitis and only causative agent that requires an etiologic diagnosis and specific treatment. S. pyogenes is of major clinical importance because it can cause post-infection systemic complications which occur after 1 – 3 weeks of the pharynx infection. S. pyogenes is responsible for 5% to 30% of cases of acute pharyngitis, and it is more common in children between 5 years and 15 years than in adults. In addition to group A streptococci several strains of bacteria can cause acute pharyngitis such as group C streptococci and group G streptococci [3a]. Common symptoms of acute pharyngitis are sore throat and fever with or without tonsillar erythema, swelling, exudate, or ulcerations. In streptococcal infections, symptom onset is usually sudden and includes sore throat, chills, malaise, fever, headache, tender and enlarged anterior cervical lymph nodes, and pharyngeal or tonsillar exudate. Scarlatina form rash and Palatal petechiae are highly specific, but rarely found. Cough, conjunctivitis, coryza and diarrhea are uncommon in streptococcal infection, and their presence suggests a viral etiology. Viruses cause approximately 75% of pharyngitis.
Treatment of GAS infections naturally depends on the use of convenient anti-biotics. GAS remains globally sensitive to penicillin, while antibiotics such as cephalosporins, macrolides, and clindamycin are also used clinically. In some regions of the world, GAS resistance to antibiotics such as clindamycin and macrolides has become an increasing worry and epidemiological wakefulness is required to ensure that treatment matches the antibiotic sensitivity of GAS strains. This study aims to isolate Streptococcus pyogenes from children with pharyngitis and to evaluate the molecular identification of S. pyogenes compared with conventional methods.
Author(s) Details:
Minas Mohamed Balla Yousif
Department of Microbiology, Faculty of Science, University of Gezira, Wad Medani, Sudan.
Adil Mergani
Department of Molecular and Immunogenetics, NCI, University of Gezira, Wad Medani, Sudan.
Mohamed Elamin A. M. E. Medani
Pediatric Cardiologist, Faculty of Medicine, University of Gezira, Wad Medani, Sudan.
Adam Dawoud Abakar
Department of Medical Parasitology, Faculty of Medical Laboratory Science, University of Gezira, Wad Medani, Sudan.
Recent Global Research Developments in Acute Pharyngitis: A Comparative Overview
Descriptive Comparison of Current Recommendations:
This study compares national and international guidelines for managing acute pharyngitis. It highlights three main strategies: antibiotic treatment for group A β-hemolytic Streptococcus (GABHS) to prevent acute rheumatic fever (ARF), considering acute pharyngitis as a self-resolving disease, and a mixed approach based on ARF risk [1] .
Differences Among International Guidelines:
This article examines the differences in guidelines from North America and Europe, focusing on the use of rapid antigen tests, throat cultures, and antibiotic indications. It emphasizes the need for a unified global strategy [1].
Impact of Antibiotic Treatment:
Research on the impact of antibiotic treatment for GABHS pharyngitis shows varying outcomes in terms of preventing complications and invasive infections. The study suggests further investigation into cost-effectiveness and local genomic epidemiology [1] .
Role of GABHS Vaccines:
This article explores the potential of GABHS vaccines as a prophylactic measure. It discusses the current state of vaccine development and its implications for reducing the global burden of GABHS disease [1] .
Quality of Guidelines:
An assessment of the quality of various guidelines using the AGREE II instrument found moderate overall quality. The study calls for a standardized approach to improve the management of acute pharyngitis worldwide [1] .
References
- Pellegrino, R., Timitilli, E., Verga, M.C. et al. Acute pharyngitis in children and adults: descriptive comparison of current recommendations from national and international guidelines and future perspectives. Eur J Pediatr 182, 5259–5273 (2023). https://doi.org/10.1007/s00431-023-05211-w
