Description
A 6-year-old boy presented to the emergency department with severe throat pain and raging fever for 1 day. The patient was unable to eat solids foods because of pain. On physical examination, cervical node lymphadenopathy, a swollen uvula and palatal petechiae were noted (figure 1). The rapid strep test is done to help quickly determine whether a sore throat is caused by a streptococcal infection. The result of a throat culture is compatible with the diagnosis of group A streptococcal pharyngitis. The patient was treated with penicillin and topical analgesia. The primary reason to treat this self-limited illness with antibiotics is to reduce the risk of complications such as rheumatic fever, meningitis, endocarditis and retropharyngeal abscess.1–3 Antibiotic therapy also reduces the risk of suppurative complications of streptococcal infection.4 A Cochrane review of randomised, placebo-controlled trials showed that antibiotic therapy significantly reduced the risks of acute otitis media and peritonsillar abscess.5 Treatment with antibiotics is effective if given within 9 days of the onset of symptoms.
Figure 1.
Palatal petechiae were noted.
Learning points.
Treat this self-limited illness with antibiotics which could reduce the risk of complications such as rheumatic fever, meningitis, endocarditis and retropharyngeal abscess.
Common symptoms include cervical node lymphadenopathy, a swollen uvula and palatal petechiae.
Footnotes
Contributors: C-JW and L-YJL performed the experiments. L-YJL, S-YW and C-YT contributed reagents/materials/analysis tools. L-YJL wrote the paper.
Funding: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests: None declared.
Provenance and peer review: Not commissioned; externally peer reviewed.
Ethics statements
Patient consent for publication
Parental/guardian consent obtained.
References
- 1.Sharp EA, Linn A, Zitelli BJ. Group A streptococcal pharyngitis associated with primary peritonitis. BMJ Case Rep 2019;12:e229186. 10.1136/bcr-2019-229186 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Mação P, Cancelinha C, Lopes P, et al. An 11-year-old boy with pharyngitis and cough: Lemierre syndrome. BMJ Case Rep 2013;2013:bcr2012008527. 10.1136/bcr-2012-008527 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Bhavsar SM, Shust GF. Invasive group G streptococcal infection in a paediatric patient. BMJ Case Rep 2016;2016:bcr2016217790. 10.1136/bcr-2016-217790 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Wessels MR. Clinical practice. Streptococcal pharyngitis. N Engl J Med 2011;364:648–55. 10.1056/NEJMcp1009126 [DOI] [PubMed] [Google Scholar]
- 5.Del Mar CB, Glasziou PP, Spinks AB. Antibiotics for sore throat. Cochrane Database Syst Rev 2006:CD000023. 10.1002/14651858.CD000023.pub3 [DOI] [PubMed] [Google Scholar]