Strep Throat

Streptococcal pyogenes pharyngitis resolves on its own within 5 days.
  • a.k.a. Lancefield Group A beta-hemolytic Strep (GABHS)
Main Reason to Tx:  Prevent Rheumatic Fever (RF)
  • RF very rare
  • Mostly 5-15 y.o., never new-onset >30
  • Inquire re: Past Hx RF, esp. immigrants from 3rd World
  • Also, to prevent transmission
Clinical Findings:  ≥3 of the Cotter criteria
  • Fever
  • Tonsillar exudate
  • Tender anterior cervical or tonsillar adenopathy
  • Absence of cough & rhinitis
Rapid Strep Test 90-95% sensitive
  • 80-90% specific (some persons colonized w/ Strep)
  • Order esp. in children
  • Order in Adults w/ clinical findings
Test Adults with Low Suspicion for Strep?
  • NO, to be cost-effective
  • NO, if easy to explain why they only have a virus
  • YES, if seek to prevent transmission
  • MAYBE, if quicker & easier than explaining to given pt on given day

See posting Sore Throat – 1 (1-3 days).

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