What Is Streptococcal Pharyngitis?

Streptococcal pharyngitis is a common disease. It is an acute inflammation of the pharyngeal mucosa, submucosal tissues, and lymphoid tissues. It is often part of upper respiratory tract infections and occurs in winter and spring. Sex. Adolescents and children are susceptible to the disease, while those less than 1 year old and above 50 rarely get the disease. This disease not only shows acute inflammation in the pharynx, but also affects the entire body and other organs to varying degrees.

Basic Information

English name

streptococcal pharyngitis

Visiting department

ENT

Multiple groups

Children

Common locations

throat

Common causes

Hemolytic streptococcus and other pyogenic streptococcal infections

Common symptoms

Chills, high fever, headache, general malaise, loss of appetite, back and limb pain, etc.

Causes of streptococcal pharyngitis

The pathogens are mostly hemolytic streptococcus and other pyogenic streptococci. Contact with hemolytic streptococcal carriers is the main cause of the disease. The carrier rate of patients with chronic tonsillitis is very high, about 40% of which are type B hemolytic streptococci. Systemic and environmental factors can be its inducement, such as malnutrition, excessive fatigue, physical weakness and other physical resistance or low immunity are susceptible to the disease. Sickness through coughing, sneezing, droplets spreading or contaminated food.

Clinical manifestations of streptococcal pharyngitis

Sudden onset, similar to the upper symptoms, followed by chills and high fever, headache, general malaise, loss of appetite, back and limb pain. Sore throat is gradually aggravated, and the symptoms can be caused by the site of inflammation. Inflammation of the pharyngeal cord causes dysphagia and pain, accompanied by earache, and inflammation of the lymphoid tissues of the tongue, with severe burning or tingling, which radiates to both ears. When it spread to the eustachian tube, there were ear tightness, tinnitus and hard of hearing. If the lesion and invasion of the throat, cough, hoarseness, dyspnea and other symptoms. Pediatric illness is severe and convulsions can occur.

Streptococcal pharyngitis examination

Physical examination

See acute congestion and swelling of the pharyngeal mucosa, especially the swelling of the mucosa of the pharyngeal side wall and the pharyngeal arch, the uvula edema, sagging, and weakness. Swelling of the lymph nodes in the neck is tender, especially in the submandibular angle, and the tenderness is obvious.

2. "Pharynx swab test"

It is a standard method for testing streptococcal pharyngitis. Under good sampling and culture techniques, its sensitivity is usually between 90% and 95%.

3. Other

The rapid streptococcus test method takes less time than the culture method, but its sensitivity is affected by the set used. If the set uses the old-style latex agglutination method, the sensitivity is only 70%. The newer set uses an enzyme-linked immunosorbent assay. 3. The sensitivity of immunophotochemical method or chemical cold light DNA probe method is between 90% and 99%.

Diagnosis of streptococcal pharyngitis

The diagnosis is based on history and clinical manifestations. The disease is relatively easy, but it should be noted that the diagnosis of complications and the identification of prodromal symptoms of acute infectious diseases are particularly important for children. After the infection, the mucosa is acutely congested and swollen, and the mucous glands are secreted. The mucosal surface is covered with thick mucus. The submucosal blood vessels and lymphocytes infiltrate around the mucous glands. The lymphatic tissue of the pharyngeal wall was also congested and swollen. In severe cases, white dot-shaped exudates were seen. The tonsils are congested and swollen, and there are shed epithelium, bacteria, metabolites and exudates in the crypt mouth to form yellow and white dots. If they are fused into a sheet, a false membrane is formed. There is a purulent phenomenon, and the lymph nodes in the neck are also enlarged.

Differential diagnosis of streptococcal pharyngitis

Scarlet fever pharyngitis

It is also a hemolytic streptococcal infection with fever and generalized skin rash. The pharyngeal manifestations are not easy to distinguish, but the rash is peculiar. From the second day of the onset, a red spotted rash occurred, which quickly spread from the neck to the extremities and extremities. The face was flushed and the mouth was pale. There was a "strawberry tongue" at the beginning of the disease, and a "poplar tongue" appeared 3 to 4 days after the onset of the disease. The rash subsided during the recovery period, and there could be significant desquamation.

2. Ulcerous membrane angina (Fensonian angina)

Pharyngeal and systemic symptoms are mild, there is an ulcerated face on one side of the tonsils or pharynx, ulcers can occur in the oral mucosa and gums, and smears can find Treponema pleisonis and clostridium.

3. Diphtheria

Pharyngeal mucosa is lightly congested, with a gray-white pseudomembrane formed on the pharyngeal wall and tonsils. The adhesions are dense and difficult to wipe off. Avoid strong wiping off. See bleeding. Pharyngeal mucosa culture and smears can detect diphtheria.

4. Adenovirus catarrhal pharyngitis

Often accompanied by ocular conjunctivitis, the so-called pharyngeal conjunctival fever, no bacterial growth in culture, and clinical symptoms are mild.

5. Granulocytosis

The mucous membrane of the pharynx is purplish red, the tonsil surface often has ulcers, the whole body is in poor condition, and there is no purulent phenomenon around the tonsil, which can be identified based on the history of blood tests.

Streptococcal pharyngitis complications

Those with no concurrent disease gradually recovered within a week. Once complications occur, it is very harmful to the body. The complications are divided into the following three categories:

Direct spread

The infection is caused by the spread of the pharynx to nearby tissues. Peritonsilitis, peritonsillar abscess, parapharyngeal abscess, retropharyngeal abscess, acute lymphadenitis, acute sinusitis, acute otitis media, acute laryngitis, trachea and bronchitis, pneumonia, etc.

2. Spread of blood

Infected menstrual circulation and other parts of the body, acute arthritis, acute osteomyelitis, sepsis, peritonitis, meningitis, etc. can occur.

3. Late complications

There are rheumatic fever, arthritis, nephritis, myocarditis and so on. These non-purulent late complications are called "morbidity after streptococcal infection." At present, it is believed that this kind of complication is not caused by direct invasion of various streptococci to various tissues, but rather a sensitive response of the tissue to this pathogen or its metabolites after infection of the pharynx.

Streptococcal pharyngitis treatment

You must rest in bed, drink plenty of water, and eat easily digestible food. For those with high fever, sore throat, and severe soreness in the whole body, appropriate application of antipyretic analgesics, such as aspirin. Pay attention to isolation and treatment to prevent transmission to others. The throat is rinsed with compound borax solution or normal saline. If you rinse with a solution containing antibiotics or a local spray, the effect is better. At the beginning of the onset, 1% iodine glycerol, 10% weak protein silver or 1% to 2% silver nitrate can be used to rub the pharyngeal wall, which will help the inflammation to fade. Neck swelling and pain in the neck should be treated with heat or physical therapy to reduce inflammation. Systemic medication is very important. At present, it is believed that iodoamine has no obvious effect on the treatment of acute pharyngitis and tonsillitis caused by hemolytic streptococcus. Penicillin has a good effect on the treatment of hemolytic streptococcal infections, so it is the drug of choice for the treatment of this disease. Depending on the condition, intramuscular or intravenous administration is used. The injection dose and use period should be increased or decreased at any time depending on the condition. Those who are allergic to or resistant to penicillin can be treated with pioneer medicine. In addition, Chinese patent medicines such as Huanglian injection, Niuhuang Jiedu pill, etc. all have certain effects.

Streptococcal pharyngitis prevention

Health education should be strengthened, physical exercise, and resistance to disease should be strengthened. Often suffering from pharyngitis and tonsillitis who have not been cured for a long time, consider tonsillectomy. Find patients and isolate and treat them in time to avoid mutual infection.