tailieunhanh - Chapter 130. Streptococcal and Enterococcal Infections (Part 3)

Clinical Manifestations Pharyngitis Although seen in patients of all ages, GAS pharyngitis is one of the most common bacterial infections of childhood, accounting for 20–40% of all cases of exudative pharyngitis in children; it is rare among those under the age of 3. Younger children may manifest streptococcal infection with a syndrome of fever, malaise, and lymphadenopathy without exudative pharyngitis. Infection is acquired through contact with another individual carrying the organism. Respiratory droplets are the usual mechanism of spread, although other routes, including food-borne outbreaks, have been well described. The incubation period is 1–4 days. Symptoms include sore throat, fever and. | Chapter 130. Streptococcal and Enterococcal Infections Part 3 Clinical Manifestations Pharyngitis Although seen in patients of all ages GAS pharyngitis is one of the most common bacterial infections of childhood accounting for 20-40 of all cases of exudative pharyngitis in children it is rare among those under the age of 3. Younger children may manifest streptococcal infection with a syndrome of fever malaise and lymphadenopathy without exudative pharyngitis. Infection is acquired through contact with another individual carrying the organism. Respiratory droplets are the usual mechanism of spread although other routes including food-borne outbreaks have been well described. The incubation period is 1-4 days. Symptoms include sore throat fever and chills malaise and sometimes abdominal complaints and vomiting particularly in children. Both symptoms and signs are quite variable ranging from mild throat discomfort with minimal physical findings to high fever and severe sore throat associated with intense erythema and swelling of the pharyngeal mucosa and the presence of purulent exudate over the posterior pharyngeal wall and tonsillar pillars. Enlarged tender anterior cervical lymph nodes commonly accompany exudative pharyngitis. The differential diagnosis of streptococcal pharyngitis includes the many other bacterial and viral etiologies Table 130-2 . Streptococcal infection is an unlikely cause when symptoms and signs suggestive of viral infection are prominent conjunctivitis coryza cough hoarseness or discrete ulcerative lesions of the buccal or pharyngeal mucosa . Because of the range of clinical presentations of streptococcal pharyngitis and the large number of other agents that can produce the same clinical picture diagnosis of streptococcal pharyngitis on clinical grounds alone is not reliable. Table 130-2 Infectious Etiologies of Acute Pharyngitis Organism Associated Clinical Syndrome s Viruses Rhinovirus Common cold Coronavirus Common cold Adenovirus .