Summary
Definição
História e exame físico
Principais fatores diagnósticos
- presence of risk factors
- child or adolescent age
- winter or spring season (in bacterial pharyngitis)
- summer/autumn season (in enteroviral pharyngitis)
- rhinorrhoea, nasal congestion, hoarseness, oral ulcers, and cough (in viral infection)
- sore throat
- pharyngeal exudate
- cervical adenopathy
- fever
- headache
- nausea, vomiting, and abdominal pain
- conjunctivitis
- maculopapular rash (in measles)
- Koplik spots (in measles)
- scarlatiniform rash (in group A Streptococcus [GAS] pharyngitis)
Outros fatores diagnósticos
- sexual activity or abuse (in HIV, gonorrhoeal, or chlamydial infection)
- treatment failure of penicillin
- pharyngeal ulceration (in tularaemia)
- pharyngeal grey membrane (in diphtheria)
Fatores de risco
- nasal colonisation with group A Streptococcus (GAS)
- GAS-infected contact
- sexual activity or abuse
- ingestion of non-domestic meats
- immunocompromised host
- use of inhaled corticosteroids
- lack of immunisation or vaccine failure
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- rapid antigen test for group A Streptococcus (GAS)
- nucleic acid amplification (via polymerase chain reaction) for group A Streptococcus (GAS)
Investigações a serem consideradas
- culture of throat swab for group A Streptococcus (GAS)
- culture or PCR of throat swab for gonococcus or chlamydia
- serum monospot for Epstein-Barr virus infection
Algoritmo de tratamento
all patients
Colaboradores
Autores
Jeffrey R. Donowitz, MD
Pediatrician
Pediatric Infectious Diseases
University of Virginia
Charlottesville
VA
Declarações
JRD declares that he has no competing interests.
Agradecimentos
Dr Jeffrey R. Donowitz would like to gratefully acknowledge Dr William A. Petri, Jr, a previous contributor to this topic.
Declarações
WAP declares that he has no competing interests.
Revisores
Richard Roberts, MD, JD, FAAFP, FCLM
Professor of Family Medicine
University of Wisconsin School of Medicine and Public Health
Madison
WI
Declarações
RR declares that he has no competing interests.
Remco de Bree, MD, PhD
Otolaryngologist
Head and Neck Surgeon
VU University Medical Center
Amsterdam
The Netherlands
Declarações
RdB declares that he has no competing interests.
Referências
Principais artigos
Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America (Archived). Clin Infect Dis. 2012 Nov 15;55(10):e86-102.Texto completo Resumo
Centers for Disease Control and Prevention. Pharyngitis (strep throat). Jun 2022 [internet publication].Texto completo
Centers for Disease Control and Prevention. Antibiotic prescribing and use - adult outpatient treatment recommendations. Oct 2017 [internet publication].Texto completo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Epiglottitis
- Retropharyngeal, peritonsillar, and lateral abscess
- Infectious mononucleosis
Mais Diagnósticos diferenciaisDiretrizes
- Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2024 update by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM)
- Pharyngitis (strep throat)
Mais DiretrizesFolhetos informativos para os pacientes
Sore throat
Mais Folhetos informativos para os pacientesConectar-se ou assinar para acessar todo o BMJ Best Practice
O uso deste conteúdo está sujeito ao nosso aviso legal