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Pharyngitis
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Streptococcal pharyngitis usually has a 5–7-day self-limiting course. Non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol are effective for symptom relief. Chlorhexidine gluconate and benzydamine hydrochloride mouthwashes can alleviate the intensity of pharyngeal discomfort and a single dose of oral or intramuscular corticosteroids (in conjunction with antibiotic therapy) can reduce pain and hasten symptom resolution.
Post-viral syndromes
Published in Avindra Nath, Joseph R. Berger, Clinical Neurovirology, 2020
Anusha K. Yeshokumar, Eliza Gordon-Lipkin, Brenda Banwell
Sydenham’s chorea is most frequently seen in children ages 8 to 9 years and is rarely seen in adults. Symptoms develop weeks to months after group-A streptococcal pharyngitis. In a study of 50 patients with rheumatic fever, chorea began unilaterally but spread to both sides in 80% of cases [58]. Diagnosis is by clinical Jones criteria (Table 25.4) and exclusion of other etiologies such as stroke, intoxication or infectious encephalitis. Antistreptolysin O or DNAse antibody titers may support evidence of streptococcal infection. Neuroimaging may be normal or transient T2 hyperintensities in the basal ganglia may be seen [59,60]. In one study of 24 children with recent onset of Sydenham’s chorea, while only two showed T2 hyperintensities on MRI in the basal ganglia, quantitative analysis revealed increased size of the basal ganglia relative to age-matched controls [61]. Other studies have demonstrated increased metabolism in the basal ganglia in two patients by PET [61] and six of ten of patients by SPECT imaging [62].
Streptococcus and Streptococcal Toxins
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
Udayakumar Prithika, Krishnaswamy Balamurugan
Depending on the species affecting the host, streptococcal infections cause a wide range of clinical symptoms. Acute rheumatic fever (ARF) is an autoimmune illness which when unrecognized or inadequately treated may cause rheumatic heart disease (RHD), a serious and sometimes fatal condition [18]. ARF has a 2–3 week period of latency before symptom onset. Arthritis occurs in about 35%–66% of patients, primarily affects large joints, and is found to be migratory [19]. Carditis arises in 50%–70% patient and is the major reason for mortality [20]. Streptococcal pharyngitis is a common infection, affecting the young age that spreads by respiratory secretions and presents after a 2- to 4-day incubation period with fever, inflamed pharynx, sore throat, tonsillar enlargement, and tender regional lymphadenopathy [21]. Scarlet fever denotes a clinical condition that is characterized by the presence of a rash along with inflammation of pharynx [22].
Acute Uveitis in a Background of Streptococcal Sepsis: Infective or Inflammatory?
Published in Ocular Immunology and Inflammation, 2023
There are few case reports in the literature describing uveitis as another clinical entity that is part of the syndrome. Gallagher, M.J et al.6 reported one such case in 2006 of a 13 year old, who presented with flu like symptoms and unilateral blurring of vision of 2 weeks onset. Ocular findings were suggestive of acute anterior uveitis and intermediate uveitis with features of vitritis. Posterior segment also showed optic disc swelling with splinter hemorrhages in the retina. This was in the background of post streptococcal pharyngitis. The patient responded well to topical and oral steroids under the cover of systemic antibiotics similar to our patient. The vast majority of cases in the literature were bilateral,1 but our case had a unilateral presentation consistent with the case reported by Gallagher, M.J et al.3
Forget-me-not: Lemierre’s syndrome, a case report
Published in Journal of American College Health, 2023
Benjamin Silverberg, Melinda J Sharon, Devan Makati, Mariah Mott, William D Rose
Sore throat is one of the most common presenting concerns in a college health clinic. Without considering the pretest probability, many practitioners reflexively test for Streptococcal pharyngitis and mononucleosis, sometimes offering antibiotics even when a bacterial infection has not been proven. Table 1 offers an extensive, albeit not exhaustive, differential diagnosis for the adolescent patient with a sore throat. Viruses are canonically thought to be the most common etiology of pharyngitis overall (reportedly up to 90% of cases in adults). Symptomatic infections due to group A beta-hemolytic streptococci (GAS) are more common in children age 5-12 years, with a lower incidence in adults (except perhaps for those who directly care for children).7 Some clinician-researchers have argued that Fusobacterium necrophorum (FN) is a major – and less recognized – cause in adolescents.1,7 Confusing the matter further, bacterial infections may follow an initial viral infection. Missed diagnoses (and thereby incorrect treatment) and rare complications can prove fatal, as is the case with rheumatic fever and Lemierre’s syndrome. Unlike GAS, no bedside confirmatory test currently exists for FN and, further, the bacterium requires an anaerobic culture medium to grow.7
Post-Streptococcal Uveitis: Case Report
Published in Ocular Immunology and Inflammation, 2019
Carlos Augusto Medina, Angela Fajardo, Ana Calderon, Manuel Aracena
Post-streptococcal uveitis is a rare disease; this is the first reported case in Colombia. It occurs mainly in young patients and children. Epidemiology is still unknown; however, in the case series reported, 96% of the cases are in patients under 40 years of age and more than half are in children under 15 years of age.3 Usually, both eyes are compromised and its manifestation is that of an anterior non-granulomatous uveitis.4,5 Although what is described in most of the case series occurs predominantly in the anterior segment, up to 35% of cases may involve posterior segment manifestation.6 As previously mentioned, uveitis occurs after a group A streptococcal infection. However, a single case has been reported in medical literature in which keratouveitis manifest itself after group C streptococcal pharyngitis.7