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Volume 21, Issue 1
  • ISSN: 1573-3963
  • E-ISSN: 1875-6336

Abstract

Background

Group A β-hemolytic (GABHS) is the leading bacterial cause of acute pharyngitis in children and adolescents worldwide.

Objective

This article aims to familiarize clinicians with the clinical manifestations, evaluation, diagnosis, and management of GABHS pharyngitis.

Methods

A search was conducted in December 2022 in PubMed Clinical Queries using the key term “group A β-hemolytic streptococcal pharyngitis”. This review covers mainly literature published in the previous ten years.

Results

Children with GABHS pharyngitis typically present with an abrupt onset of fever, intense pain in the throat, pain on swallowing, an inflamed pharynx, enlarged and erythematous tonsils, a red and swollen uvula, enlarged tender anterior cervical lymph nodes. As clinical manifestations may not be specific, even experienced clinicians may have difficulties diagnosing GABHS pharyngitis solely based on epidemiologic or clinical grounds alone. Patients suspected of having GABHS pharyngitis should be confirmed by microbiologic testing (., culture, rapid antigen detection test, molecular point-of-care test) of a throat swab specimen prior to the initiation of antimicrobial therapy. Microbiologic testing is generally unnecessary in patients with pharyngitis whose clinical and epidemiologic findings do not suggest GABHS. Clinical score systems such as the Centor score and McIssac score have been developed to help clinicians decide which patients should undergo diagnostic testing and reduce the unnecessary use of antimicrobials. Antimicrobial therapy should be initiated without delay once the diagnosis is confirmed. Oral penicillin V and amoxicillin remain the drugs of choice. For patients who have a non-anaphylactic allergy to penicillin, oral cephalosporin is an acceptable alternative. For patients with a history of immediate, anaphylactic-type hypersensitivity to penicillin, oral clindamycin, clarithromycin, and azithromycin are acceptable alternatives.

Conclusion

Early diagnosis and antimicrobial treatment are recommended to prevent suppurative complications (., cervical lymphadenitis, peritonsillar abscess) and non-suppurative complications (particularly rheumatic fever) as well as to reduce the severity of symptoms, to shorten the duration of the illness and to reduce disease transmission.

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References

  1. AshurstJ.V. Edgerley-GibbL. Streptococcal pharyngitis.Treasure Island, FLStatPearls Publishing2022
     [Google Scholar]
  2. MillerK.M. TanzR.R. ShulmanS.T. Standardization of epidemiological surveillance of group a streptococcal pharyngitis.Open Forum Infect. Dis.202291S5S1410.1093/ofid/ofac251 36128410
     [Google Scholar]
  3. LeungA.K.C. KellnerJ.D. Group A β-hemolytic streptococcal pharyngitis in children.Adv. Ther.200421527728710.1007/BF02850032 15727397
     [Google Scholar]
  4. American Academy of Pediatrics. Group A streptococcal infectiond.Red Book: 2021-2024 Report of the Committee on Infectious Diseases. 32nd ed. KimberlinDW BarnettED LynfieldR SwayerMH American Academy of PediatricsItasca, IL2021694707
     [Google Scholar]
  5. BisnoA.L. GerberM.A. GwaltneyJ.M.Jr KaplanE.L. SchwartzR.H. Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis.Clin. Infect. Dis.200235211312510.1086/340949 12087516
     [Google Scholar]
  6. ChiappiniE. RegoliM. BonsignoriF. Analysis of different recommendations from international guidelines for the management of acute pharyngitis in adults and children.Clin. Ther.2011331485810.1016/j.clinthera.2011.02.001 21397773
     [Google Scholar]
  7. GerberM.A. BaltimoreR.S. EatonC.B. Prevention of rheumatic fever and diagnosis and treatment of acute streptococcal pharyngitis.Circulation2009119111541155110.1161/CIRCULATIONAHA.109.191959 19246689
     [Google Scholar]
  8. PelucchiC. GrigoryanL. GaleoneC. Guideline for the management of acute sore throat: ESCMID sore throat guideline group.Clin. Microbiol. Infect.201218112810.1111/j.1469‑0691.2012.03766.x
     [Google Scholar]
  9. RandelA. IDSA updates guideline for managing group A streptococcal pharyngitis.Am. Fam. Physician2013885338340 24010402
     [Google Scholar]
  10. ShulmanS.T. BisnoA.L. CleggH.W. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the infectious diseases society of america.Clin. Infect. Dis.20125510e86e10210.1093/cid/cis629 22965026
     [Google Scholar]
  11. ShulmanS.T. BisnoA.L. CleggH.W. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the infectious diseases society of america.Clin. Infect. Dis.201255101279128210.1093/cid/cis847 23091044
     [Google Scholar]
  12. SnowV. Mottur-PilsonC. CooperR.J. HoffmanJ.R. Principles of appropriate antibiotic use for acute pharyngitis in adults.Ann. Intern. Med.2001134650650810.7326/0003‑4819‑134‑6‑200103200‑00018 11255529
     [Google Scholar]
  13. MazurE. Management of acute streptococcal pharyngitis: Still the subject of controversy.Open Med.20138671371910.2478/s11536‑013‑0216‑z 32215121
     [Google Scholar]
  14. Di MuzioI. d’AngeloD.M. Di BattistaC. Pediatrician’s approach to diagnosis and management of group A streptococcal pharyngitis.Eur. J. Clin. Microbiol. Infect. Dis.20203961103110710.1007/s10096‑020‑03821‑y 31984431
     [Google Scholar]
  15. LuoR. SicklerJ. VahidniaF. LeeY.C. FrognerB. ThompsonM. Diagnosis and management of group a streptococcal pharyngitis in the United States, 2011-2015.BMC Infect. Dis.201919119310.1186/s12879‑019‑3835‑4 30808305
     [Google Scholar]
  16. SarrellE.M. GiveonS.M. Streptococcal pharyngitis: A prospective study of compliance and complications.ISRN Pediatr.201220121810.5402/2012/796389 22778988
     [Google Scholar]
  17. ThompsonJ.M. ZagelA.L. SpauldingA.B. KrauseE.A. ArmsJ.L. Streptococcal pharyngitis.Pediatr. Emerg. Care2022382e519e52310.1097/PEC.0000000000002512 34417790
     [Google Scholar]
  18. TranJ. DanchinM. PirottaM. SteerA.C. Management of sore throat in primary care.Aust. J. Gen. Pract.201847748548910.31128/AJGP‑11‑17‑4393 30114874
     [Google Scholar]
  19. LeungT.N.H. HonK.L. LeungA.K.C. GroupA. Streptococcus disease in Hong Kong children: An overview.Hong Kong Med. J.201824659360110.12809/hkmj187275 30416105
     [Google Scholar]
  20. LeungA.K.C. Group A β-hemolytic streptococcal pharyngitis.Common Problems in Ambulatory Pediatrics: Specific Clinical ProblemsNova Science Publishers, IncNew York20111247255
     [Google Scholar]
  21. NewbergerR. GuptaV. Streptococcus group A.Treasure Island, FLStatPearls Publishing2022 3264466
     [Google Scholar]
  22. ShulmanS.T. TanzR.R. Group A streptococcal pharyngitis and immune-mediated complications: From diagnosis to management.Expert Rev. Anti Infect. Ther.20108213715010.1586/eri.09.134 20109044
     [Google Scholar]
  23. NortonL. MyersA. The treatment of streptococcal tonsillitis/pharyngitis in young children.World J. Otorhinolaryngol. Head Neck Surg.20217316116510.1016/j.wjorl.2021.05.005 34430823
     [Google Scholar]
  24. StollermanG.H. DaleJ.B. The importance of the group a streptococcus capsule in the pathogenesis of human infections: A historical perspective.Clin. Infect. Dis.20084671038104510.1086/529194 18444821
     [Google Scholar]
  25. TanzR.R. GewitzM.H. KaplanE.L. ShulmanS.T. Stay the course: Targeted evaluation, accurate diagnosis, and treatment of streptococcal pharyngitis prevent acute rheumatic fever.J. Pediatr.202021620821210.1016/j.jpeds.2019.08.042 31561955
     [Google Scholar]
  26. AlcaideM.L. BisnoA.L. Pharyngitis and epiglottitis.Infect. Dis. Clin. North Am.200721244946910.1016/j.idc.2007.03.001
     [Google Scholar]
  27. JaggiP. ShulmanS.T. Group A streptococcal infections.Pediatr. Rev.20062739910510.1542/pir.27.3.99 16510550
     [Google Scholar]
  28. ShaikhN. LeonardE. MartinJ.M. Prevalence of streptococcal pharyngitis and streptococcal carriage in children: A meta-analysis.Pediatrics20101263e557e56410.1542/peds.2009‑2648 20696723
     [Google Scholar]
  29. AhluwaliaT. JainS. NortonL. MeadeJ. Etherton-StillJ. MyersA. Reducing streptococcal testing in patients <3 years old in an emergency department.Pediatrics20191444e2019017410.1542/peds.2019‑0174 31511313
     [Google Scholar]
  30. SauveL. ForresterA.M. TopK.A. Group A streptococcal pharyngitis: A practical guide to diagnosis and treatment.Paediatr. Child Health202126531932010.1093/pch/pxab025 34336062
     [Google Scholar]
  31. WiD. ChoiS.H. Positive rate of tests for group A streptococcus and viral features in children with acute pharyngitis.Children20218759910.3390/children8070599 34356578
     [Google Scholar]
  32. SharifM.R. AalinezhadM. SajadianS.M.S. Haji RezaeiM. Streptococcal pharyngitis in a two-month-old infant: A case report.Jundishapur J. Microbiol.201695e3263010.5812/jjm.32630 27540457
     [Google Scholar]
  33. BorchardtR.A. Diagnosis and management of group A beta-hemolytic streptococcal pharyngitis.JAAPA2013269535410.1097/01.JAA.0000433876.39648.5224069674
     [Google Scholar]
  34. KronmanM.P. ZhouC. Mangione-SmithR. Bacterial prevalence and antimicrobial prescribing trends for acute respiratory tract infections.Pediatrics20141344e956e96510.1542/peds.2014‑0605 25225144
     [Google Scholar]
  35. MustafaZ. GhaffariM. Diagnostic methods, clinical guidelines, and antibiotic treatment for group A streptococcal pharyngitis: A narrative review.Front. Cell. Infect. Microbiol.20201056362710.3389/fcimb.2020.563627 33178623
     [Google Scholar]
  36. KennisM. TagawaA. KungV.M. Seasonal variations and risk factors of Streptococcus pyogenes infection: A multicenter research network study.Ther. Adv. Infect. Dis.2022910.1177/20499361221132101 36277299
     [Google Scholar]
  37. WaldER Group A streptococcal tonsillopharyngitis in children and adolescents: Clinical features and diagnosis.UpToDate.
     [Google Scholar]
  38. LangloisD.M. AndreaeM. Group A streptococcal infections.Pediatr. Rev.2011321042343010.1542/pir.32.10.423 21965709
     [Google Scholar]
  39. TakayamaY. HikawaS. OkadaJ. SunakawaK. AkahoshiT. A foodborne outbreak of a group A streptococcal infection in a Japanese university hospital.Eur. J. Clin. Microbiol. Infect. Dis.200928330530810.1007/s10096‑008‑0614‑3 18716803
     [Google Scholar]
  40. BennettJ MorelandNJ ZhangJ Risk factors for group A streptococcal pharyngitis and skin infections: A case control study.Lancet Regional Health - Western Pacific20222610050710.1016/j.lanwpc.2022.10050735789826
     [Google Scholar]
  41. AstebergI. AnderssonY. DotevallL. A food-borne streptococcal sore throat outbreak in a small community.Scand. J. Infect. Dis.20063811-1298899410.1080/00365540600868370 17148066
     [Google Scholar]
  42. CulquiD.R. Manzanares-LayaS. Van Der SluisS.L. Group A β-hemolytic streptococcal pharyngotonsillitis outbreak.Rev. Saude Publica201448232232510.1590/S0034‑8910.2014048005091 24897054
     [Google Scholar]
  43. KembleS.K. WestbrookA. LynfieldR. Foodborne outbreak of group a streptococcus pharyngitis associated with a high school dance team banquet-Minnesota, 2012.Clin. Infect. Dis.201357564865410.1093/cid/cit359 23868521
     [Google Scholar]
  44. WesselsM.R. Streptococcal Pharyngitis.N. Engl. J. Med.2011364764865510.1056/NEJMcp1009126 21323542
     [Google Scholar]
  45. LevinR.M. GrossmanM. JordanC. TicknorW. BarnettP. PascoeD. Group A streptococcal infection in children younger than three years of age.Pediatr. Infect. Dis. J.198878581587 3050854
     [Google Scholar]
  46. AnjosL.M.M. MarcondesM.B. LimaM.F. MondelliA.L. OkoshiM.P. Streptococcal acute pharyngitis.Rev. Soc. Bras. Med. Trop.201447440941310.1590/0037‑8682‑0265‑2013 25229278
     [Google Scholar]
  47. EbellM.H. Diagnosis of streptococcal pharyngitis.Am. Fam. Physician20148912976977 25162166
     [Google Scholar]
  48. LiL.Y.J. WangS.Y. TsaiC.Y. WuC.J. Group A streptococcal pharyngitis.BMJ Case Rep.2021149e24487110.1136/bcr‑2021‑244871 34593551
     [Google Scholar]
  49. NasirianH. TarvijEslami S, Matini E, Bayesh S, Omaraee Y. A clinical decision rule for streptococcal pharyngitis management: An update.J. Lab. Physicians20179211612010.4103/0974‑2727.199635 28367027
     [Google Scholar]
  50. SahuM. SahooP.R. Strawberry tongue in streptococcal pharyngitis.N. Engl. J. Med.202138412114410.1056/NEJMicm2026930 33761210
     [Google Scholar]
  51. InamadarA.C. AdyaK.A. PalitA. The strawberry tongue: What, how and where?Indian J. Dermatol. Venereol. Leprol.201884450050510.4103/ijdvl.IJDVL_57_17 29620043
     [Google Scholar]
  52. PardoS. PereraT.B. Scarlet fever.Treasure Island, FLStatPearls Publishing2022
     [Google Scholar]
  53. SilA. ChakrabortyS. BhanjaD.B. MondalS. PanigrahiA. Doughnut lesions over palate in streptococcal pharyngitis.Indian J. Pediatr.202087757310.1007/s12098‑020‑03242‑x 32088912
     [Google Scholar]
  54. JoS.A. MaS.H. KimS. Diagnostic impact of clinical manifestations of group A streptococcal pharyngitis.Infect. Chemother.202153355355610.3947/ic.2021.0042 34623782
     [Google Scholar]
  55. SykesE.A. WuV. BeyeaM.M. SimpsonM.T.W. BeyeaJ.A. Pharyngitis: Approach to diagnosis and treatment.Can. Fam. Physician2020664251257 32273409
     [Google Scholar]
  56. PankhurstC.L. Candidiasis (oropharyngeal).Clin. Evid.201320131304 24209593
     [Google Scholar]
  57. GottliebM. LongB. KoyfmanA. Clinical mimics: An emergency medicine-focused review of streptococcal pharyngitis mimics.J. Emerg. Med.201854561962910.1016/j.jemermed.2018.01.031 29523424
     [Google Scholar]
  58. LeungA.K.C. RafaatM. Eruption associated with amoxicillin in a patient with infectious mononucleosis.Int. J. Dermatol.200342755355510.1046/j.1365‑4362.2003.01699_1.x 12839608
     [Google Scholar]
  59. LeungA.K.C. WongA.H. LeongK.F. Infectious mononucleosis: Clinical manifestations, investigations, and management.Advances in Health and Disease.Nova Science Publishers, IncNew York201864571
     [Google Scholar]
  60. LeungA.K. ChoH. Diagnosis of stridor in children.Am. Fam. Physician199960822892296 10593320
     [Google Scholar]
  61. FleisherGR FineAM Evaluation of sore throat in children. UpToDate.
     [Google Scholar]
  62. LamichhaneA. RadhakrishnanS. In: StatPearls.Treasure Island, FLStatPearls Publishing2022
     [Google Scholar]
  63. LeungA.K.C. SergiC.M. LeongK.F. KantorP.F. MdMd. Visual diagnosis: High fever, maculopapular rash, perianal desquamation, and conjunctivitis in a 3-year-old boy.Pediatr. Rev.2021425e17e2210.1542/pir.2018‑0330 33931516
     [Google Scholar]
  64. LooS.K. HonK.L. LeungA.K.C. YungT.C. YamM.C. Kawasaki disease in siblings and a review of drug treatment.Drugs Context202091510.7573/dic.2020‑4‑1 32699547
     [Google Scholar]
  65. YuH. LiX.W. LiuQ.B. Diagnosis and treatment of herpangina: Chinese expert consensus.World J. Pediatr.202016212913410.1007/s12519‑019‑00277‑9 31347021
     [Google Scholar]
  66. HonK.L. LeungA.K.C. LeungK. ChanG.C.F. Measles outbreak at an international airport: A Hong Kong perspective.Hong Kong Med. J.201925433133310.12809/hkmj197962 31416996
     [Google Scholar]
  67. LeungA.K.C. HonK.L. LeongK.F. SergiC.M. Measles: A disease often forgotten but not gone.Hong Kong Med. J.201824551252010.12809/hkmj187470 30245481
     [Google Scholar]
  68. HoyN.Y. LeungA.K.C. MetelitsaA.I. AdamsS. New concepts in median nail dystrophy, onychomycosis, and hand, foot, and mouth disease nail pathology.ISRN Dermatol.201220121510.5402/2012/680163 22462009
     [Google Scholar]
  69. LeungA.K.C. LamJ.M. BarankinB. LeongK.F. HonK.L. Hand, foot, and mouth disease: A narrative review.Recent Adv Inflamm Allergy Drug Discov2022162779510.2174/1570180820666221024095837
     [Google Scholar]
  70. LeungA.K.C. KaoC.P. SauveR.S. Scarring resulting from chickenpox.Pediatr. Dermatol.200118537838010.1046/j.1525‑1470.2001.01975.x 11737678
     [Google Scholar]
  71. AdilA. GoyalA. QuintJ.M. Behcet disease.Treasure Island, FLStatPearls Publishing2022
     [Google Scholar]
  72. KhemissM. HajjajS. BlouzaI. BejiM. Oral manifestations of Behçet’s disease.Tunis. Med.20221004303308 36155901
     [Google Scholar]
  73. OhnishiT. SatoS. UejimaY. KawanoY. SuganumaE. Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome: Clinical characteristics and treatment outcomes - a single center study in Japan.Pediatr. Int.2022641e1529410.1111/ped.15294 36134651
     [Google Scholar]
  74. ShaikhN. SwaminathanN. HooperE.G. Accuracy and precision of the signs and symptoms of streptococcal pharyngitis in children: A systematic review.J. Pediatr.20121603487493.e310.1016/j.jpeds.2011.09.011 22048053
     [Google Scholar]
  75. ShahR. BansalA. SinghiS.C. Approach to a child with sore throat.Indian J. Pediatr.201178101268127210.1007/s12098‑011‑0467‑0 21660400
     [Google Scholar]
  76. BirdC WinzorG LemonK MoffatA NewtonT GrayJ. A pragmatic study to evaluate the use of a rapid diagnostic test to detect group A streptococcal pharyngitis in children with the aim of reducing antibiotic use in a UK emergency department.Pediatr Emerg Care Publish Ahead of Print.20185e24925110.1097/PEC.000000000000156030045356
     [Google Scholar]
  77. CentorR.M. WitherspoonJ.M. DaltonH.P. BrodyC.E. LinkK. The diagnosis of strep throat in adults in the emergency room.Med. Decis. Making19811323924610.1177/0272989X8100100304 6763125
     [Google Scholar]
  78. McIsaacW.J. WhiteD. TannenbaumD. LowD.E. A clinical score to reduce unnecessary antibiotic use in patients with sore throat.CMAJ199815817583 9475915
     [Google Scholar]
  79. NawazH. SmithD.S. MazhariR. KatzD.L. Concordance of clinical findings and clinical judgment in the diagnosis of streptococcal pharyngitis.Acad. Emerg. Med.20007101104110910.1111/j.1553‑2712.2000.tb01259.x 11015241
     [Google Scholar]
  80. ScienceM. BitnunA. McIsaacW. Identifying and treating group A streptococcal pharyngitis in children.CMAJ201518711310.1503/cmaj.141532 25512654
     [Google Scholar]
  81. BoZ.M. TanW.K. ChongC.S.C. Respiratory microorganisms in acute pharyngitis patients: Identification, antibiotic prescription patterns and appropriateness, and antibiotic resistance in private primary care, central Malaysia.PLoS One20221711e027780210.1371/journal.pone.0277802 36395327
     [Google Scholar]
  82. Le MarechalF. MartinotA. DuhamelA. PruvostI. DubosF. Streptococcal pharyngitis in children: A meta-analysis of clinical decision rules and their clinical variables.BMJ Open201333e00148210.1136/bmjopen‑2012‑001482 23474784
     [Google Scholar]
  83. MuthannaA. ShamsuddinN.H. Abdul RashidA. Diagnostic accuracy of Centor score for diagnosis of group A streptococcal pharyngitis among adults in primary care clinics in Malaysia.Malays. J. Med. Sci.2022294889710.21315/mjms2022.29.4.9 36101529
     [Google Scholar]
  84. BaylessS. BihlT. RohanC.A. TraversJ.B. WhitneyE. Inappropriate testing of streptococcal pharyngitis in children aged below 3 years: Application of statistical process control.Clin. Pediatr. (Phila.)20229922822112582310.1177/00099228221125823 36171730
     [Google Scholar]
  85. de Moraes-PintoM.I. Streptococcal pharyngotonsillitis: Need of microbiological tests in order to have a precise diagnosis.Rev. Paul. Pediatr.20133112310.1590/S0103‑05822013000100001 23703036
     [Google Scholar]
  86. ShapiroD.J. LindgrenC.E. NeumanM.I. FineA.M. Viral features and testing for streptococcal pharyngitis.Pediatrics20171395e2016340310.1542/peds.2016‑3403 28557742
     [Google Scholar]
  87. KaplanE.L. GastanaduyA.S. HuweB.B. The role of the carrier in treatment failures after antibiotic for group A streptococci in the upper respiratory tract.J. Lab. Clin. Med.1981983326335 7021717
     [Google Scholar]
  88. Pichichero ME. Treatment and prevention of streptococcal tonsillopharyngitis in adults and children. In: Post, TW, ed. UpToDate. Waltham, MA. (Accessed on December 1, 2022).
  89. ChobyB.A. Diagnosis and treatment of streptococcal pharyngitis.Am. Fam. Physician2009795383390 19275067
     [Google Scholar]
  90. AzradM. DanilovE. GoshenS. NitzanO. PeretzA. Detection of group a Streptococcus in pharyngitis by two rapid tests: Comparison of the BD Veritor™ and the QuikRead go® Strep A.Eur. J. Clin. Microbiol. Infect. Dis.20193861179118510.1007/s10096‑019‑03527‑w 30852698
     [Google Scholar]
  91. LeungA.K.C. NewmanR. KumarA. DaviesH.D. Rapid antigen detection testing in diagnosing group A β-hemolytic streptococcal pharyngitis.Expert Rev. Mol. Diagn.20066576176610.1586/14737159.6.5.761 17009909
     [Google Scholar]
  92. HendiS.B. MalikZ.A. KhamisA.H. Al-NajjarF.Y.A. High diagnostic accuracy of automated rapid Strep A test reduces antibiotic prescriptions for children in the United Arab Emirates.BMC Pediatr.20212115210.1186/s12887‑021‑02516‑3 33494718
     [Google Scholar]
  93. CohenJ.F. BertilleN. CohenR. ChalumeauM. Rapid antigen detection test for group A streptococcus in children with pharyngitis.Cochrane Libr.201620167CD01050210.1002/14651858.CD010502.pub2 27374000
     [Google Scholar]
  94. KüçükÖ. BiçerS. GirayT. Validity of rapid antigen detection testing in group A beta-hemolytic streptococcal tonsillopharyngitis.Indian J. Pediatr.201481213814210.1007/s12098‑013‑1067‑y 23749414
     [Google Scholar]
  95. EhrlichJ.E. DemopoulosB.P. DanielK.R.Jr RicarteM.C. GliedS. Cost-effectiveness of treatment options for prevention of rheumatic heart disease from Group A streptococcal pharyngitis in a pediatric population.Prev. Med.200235325025710.1006/pmed.2002.1062 12202067
     [Google Scholar]
  96. LeanW.L. ArnupS. DanchinM. SteerA.C. Rapid diagnostic tests for group A streptococcal pharyngitis: A meta-analysis.Pediatrics2014134477178110.1542/peds.2014‑1094 25201792
     [Google Scholar]
  97. BilirS.P. KrugerE. FallerM. US cost-effectiveness and budget impact of point-of-care NAAT for streptococcus.Am. J. Manag. Care2021275e157e16310.37765/ajmc.2021.88638 34002967
     [Google Scholar]
  98. DuboisC. SmeestersP.R. RefesY. Diagnostic accuracy of rapid nucleic acid tests for group A streptococcal pharyngitis: Systematic review and meta-analysis.Clin. Microbiol. Infect.202127121736174510.1016/j.cmi.2021.04.021 33964409
     [Google Scholar]
  99. ToptanH AgelE SagcanH Rapid molecular diagnosis of group A streptococcus with a novel loop mediated isothermal amplification method.Clin Lab202268(08/2022)10.7754/Clin.Lab.2021.21092535975490
     [Google Scholar]
  100. DunneE.M. MarshallJ.L. BakerC.A. Detection of group a streptococcal pharyngitis by quantitative PCR.BMC Infect. Dis.201313131210.1186/1471‑2334‑13‑312 23844865
     [Google Scholar]
  101. FelsensteinS. FaddoulD. SpostoR. BatoonK. PolancoC.M. Dien BardJ. Molecular and clinical diagnosis of group A streptococcal pharyngitis in children.J. Clin. Microbiol.201452113884388910.1128/JCM.01489‑14 25143573
     [Google Scholar]
  102. GantiL. LongB.J. What is the diagnostic accuracy of rapid nucleic acid tests for group A streptococcal pharyngitis?Ann. Emerg. Med.202279438839010.1016/j.annemergmed.2021.09.421 34756451
     [Google Scholar]
  103. GrafE.H. Can rapid molecular Streptococcus pyogenes testing lead to better antimicrobial stewardship for acute pharyngitis?J. Appl. Lab. Med.20194214014210.1373/jalm.2019.029983 31639658
     [Google Scholar]
  104. JaggiP. LeberA. Molecular testing for group A streptococcal pharyngitis: To test or not to test, that is the question.J. Pediatric Infect. Dis. Soc.201810.1093/jpids/pix106 29718291
     [Google Scholar]
  105. RaoA. BergB. QuezadaT. Diagnosis and antibiotic treatment of group a streptococcal pharyngitis in children in a primary care setting: Impact of point-of-care polymerase chain reaction.BMC Pediatr.20191912410.1186/s12887‑019‑1393‑y 30651115
     [Google Scholar]
  106. RobinsonJ.L. Paediatrics: How to manage pharyngitis in an era of increasing antimicrobial resistance.Drugs Context202020211010.7573/dic.2020‑11‑6 33828608
     [Google Scholar]
  107. ShapiroD.J. FineA.M. HershA.L. BourgeoisF.T. Association between molecular streptococcal testing and antibiotic use for pharyngitis in children.J. Pediatric Infect. Dis. Soc.202211630330410.1093/jpids/piac008 35253892
     [Google Scholar]
  108. TanzR.R. HeaberlinL.E. HarveyE. Performance of a molecular test for group A streptococcus pharyngitis.J. Pediatric Infect. Dis. Soc.2023121565910.1093/jpids/piac115 36322677
     [Google Scholar]
  109. TaylorA. MorpethS. WebbR. TaylorS. The utility of rapid group A streptococcus molecular testing compared with throat culture for the diagnosis of group A streptococcal pharyngitis in a high-incidence rheumatic fever population.J. Clin. Microbiol.20215912e00978e2110.1128/JCM.00978‑21 34550808
     [Google Scholar]
  110. PrittB.S. PatelR. KirnT.J. ThomsonR.B.Jr Point-counterpoint: A nucleic acid amplification test for streptococcus pyogenes should replace antigen detection and culture for detection of bacterial pharyngitis.J. Clin. Microbiol.201654102413241910.1128/JCM.01472‑16 27440817
     [Google Scholar]
  111. RuppertS.D. FayV.P. Pharyngitis.Nurse Pract.2015407182510.1097/01.NPR.0000466498.57296.60 26080293
     [Google Scholar]
  112. StuempfigN.D. SeroyJ. Monospot test.Treasure Island, FLStatPearls Publishing2021
     [Google Scholar]
  113. WangE.X. KussmanA. HwangC.E. Use of Monospot testing in the diagnosis of infectious mononucleosis in the collegiate student-athlete population.Clin. J. Sport Med.202232546747010.1097/JSM.0000000000000996 36083325
     [Google Scholar]
  114. ChristensenA.M.G. ThomsenM.K. OvesenT. KlugT.E. Are procalcitonin or other infection markers useful in the detection of group A streptococcal acute tonsillitis?Scand. J. Infect. Dis.201446537638310.3109/00365548.2014.885656 24606046
     [Google Scholar]
  115. YuJ. TycksenE. YangW. Use of host response to refine the diagnosis of group A streptococcal pharyngitis.J. Pediatric Infect. Dis. Soc.2022111148249110.1093/jpids/piac072 36153766
     [Google Scholar]
  116. BellaZ. ErdelyiE. Szalenko-TőkésÁ. Peritonsillar abscess: An 8-year retrospective, culture based evaluation of 208 cases.J. Med. Microbiol.202271910.1099/jmm.0.001576 36107755
     [Google Scholar]
  117. AlexandreM. Wang’onduR. CooneyL.M.Jr Group A streptococcal bacteremia following streptococcal pharyngitis in an older patient with diabetes: A case report.Yale J. Biol. Med.2017902337340 28656020
     [Google Scholar]
  118. ZinkJ.U. MorseB.C. VercruysseG.A. DenteC.J. JonesY.R. FelicianoD.V. Remote group A β-hemolytic Streptococcal fasciitis and myositis: A rare complication from hematogenous spread of Streptococcal pharyngitis.Am. Surg.201379929629710.1177/000313481307900905 24069966
     [Google Scholar]
  119. TaniguchiH. AimiM. MatsushitaH. ShimazakiG. A case of phlegmonous gastritis after acute pharyngitis.Clin. J. Gastroenterol.202114250050510.1007/s12328‑021‑01345‑2 33539005
     [Google Scholar]
  120. SharpE.A. LinnA. ZitelliB.J. Group A streptococcal pharyngitis associated with primary peritonitis.BMJ Case Rep.2019125e22918610.1136/bcr‑2019‑229186 31061197
     [Google Scholar]
  121. SheikhS. JavedU. BaigM.A. Streptococcal pharyngitis: Delving deeper than the throat.J. Coll. Physicians Surg. Pak.202131673273410.29271/jcpsp.2021.06.732 34102792
     [Google Scholar]
  122. ShahR.K. WoffordM.M. WestT.G. ShettyA.K. Lemierre syndrome associated with group A streptococcal infection.Am. J. Emerg. Med.2010285643.e5643.e810.1016/j.ajem.2009.09.011 20579574
     [Google Scholar]
  123. PichicheroME Complications of streptococcal tonsillopharyngitis. UpToDate.
     [Google Scholar]
  124. WaldenJ.H. HessB. RigbyM. Streptococcal pharyngitis: An uncommon cause of subdural empyema.BMJ Case Rep.20152015bcr201521131210.1136/bcr‑2015‑211312 26385939
     [Google Scholar]
  125. ScheelA. BeatonA.Z. KatzenellenbogenJ. Standardization of epidemiological surveillance of acute rheumatic fever.Open Forum Infect. Dis.20229Suppl. 1S41S4910.1093/ofid/ofac252 36128408
     [Google Scholar]
  126. KulikE. StuartB. WillcoxM. Predictors of rheumatic fever in sore throat patients: A systematic review and meta-analysis.Trans. R. Soc. Trop. Med. Hyg.2022116428629710.1093/trstmh/trab156 34636404
     [Google Scholar]
  127. NoguchiK. ArainN. GallowayC. Acute rheumatic fever: Case report and literature review.S. D. Med.2022755212215 35724350
     [Google Scholar]
  128. SatoS. UejimaY. SuganumaE. TakanoT. KawanoY. A retrospective study: Acute rheumatic fever and post-streptococcal reactive arthritis in Japan.Allergol. Int.201766461762010.1016/j.alit.2017.04.001 28442182
     [Google Scholar]
  129. SchmutzlerL. MirnaM. HoppeU.C. LichtenauerM. From streptococcal pharyngitis/tonsillitis to myocarditis: A systematic review.J. Cardiovasc. Dev. Dis.20229617010.3390/jcdd9060170 35735799
     [Google Scholar]
  130. DooleyL.M. AhmadT.B. PandeyM. GoodM.F. KotiwM. Rheumatic heart disease: A review of the current status of global research activity.Autoimmun. Rev.202120210274010.1016/j.autrev.2020.102740 33333234
     [Google Scholar]
  131. PancholiaA.K. VijaylakshmiI.B. Mohan RaoP.S. Rheumatic heart disease in India in 2020: Advances in diagnostic and therapeutic options.J. Assoc. Physicians India20227011112 35062813
     [Google Scholar]
  132. RwebemberaJ. NascimentoB.R. MinjaN.W. Recent advances in the rheumatic fever and rheumatic heart disease continuum.Pathogens202211217910.3390/pathogens11020179 35215123
     [Google Scholar]
  133. AllenJ. MunozC. ByakovaA. PachulskiR. Acute fulminant group A beta-hemolytic streptococcus-associated carditis: A case report and literature review.Cureus2022147e2728210.7759/cureus.27282 36039237
     [Google Scholar]
  134. BoruahP. ShettyS. KumarS.S. Acute streptococcal myocarditis presenting as acute ST-elevation myocardial infarction.J. Invasive Cardiol.20102210E189E191 20944196
     [Google Scholar]
  135. ChaudhuriA. DoorisM. WoodsM.L. Non-rheumatic streptococcal myocarditis – warm hands, warm heart.J. Med. Microbiol.201362116917210.1099/jmm.0.049569‑0 23002069
     [Google Scholar]
  136. HiraiwaH. MorimotoR. AndoR. Recurrent fulminant non-rheumatic streptococcal myocarditis proven by endomyocardial biopsy and autopsy.J. Cardiol. Cases2022261626510.1016/j.jccase.2022.02.004 35923528
     [Google Scholar]
  137. KalpakosT. WilgenhofA. MichielsV. CosynsB. VermeerschP. Streptococcal pharyngitis associated myocarditis (SPAM): The perfect ST-segment elevation myocardial infarction (STEMI) mimic in young individuals. A case series.Acta Cardiol.202176544945410.1080/00015385.2020.1854985 33283669
     [Google Scholar]
  138. MavrogeniS. BratisK. KitsiouA. KolovouG. Streptococcal tonsillitis and acute streptococcal myocarditis: An unusual combination assessed by cardiac magnetic resonance imaging and endomyocardial biopsy.Ann. Otol. Rhinol. Laryngol.2012121960460810.1177/000348941212100907 23012899
     [Google Scholar]
  139. MokabberiR. ShiraniJ. M AH, Go BD, Schiavone W. Streptococcal pharyngitis-associated myocarditis mimicking acute STEMI.JACC Cardiovasc. Imaging20103889289310.1016/j.jcmg.2010.05.012 20705272
     [Google Scholar]
  140. Limm-ChanB. MusgraveJ. LauR. AhnH.J. NguyenL. KuraharaD. Incidence of acute post-streptococcal glomerulonephritis in Hawai’i and factors affecting length of hospitalization.Hawaii J. Health Soc. Welf.2020795149152 32432220
     [Google Scholar]
  141. MartinJ. KaulA. SchachtR. Acute poststreptococcal glomerulonephritis: A manifestation of immune reconstitution inflammatory syndrome.Pediatrics20121303e710e71310.1542/peds.2011‑1246 22891230
     [Google Scholar]
  142. OngL.T. Management and outcomes of acute post-streptococcal glomerulonephritis in children.World J. Nephrol.202211513914510.5527/wjn.v11.i5.139 36187464
     [Google Scholar]
  143. RobsonW.L. LeungA.K. Post-streptococcal glomerulonephritis with minimal abnormalities in the urinary sediment.J. Singapore Paediatr. Soc.1992343-4232234 1305669
     [Google Scholar]
  144. RobsonW.L. LeungA.K. Post-streptococcal glomerulonephritis.Clin. Nephrol.1995432139 7794396
     [Google Scholar]
  145. SpernovasilisN. StylianouK. MilioniA. PanagiotakisS. Microscopic polyangiitis after streptococcal pharyngitis in a young woman.Postgrad. Med. J.201894111872810.1136/postgradmedj‑2018‑135674 30282781
     [Google Scholar]
  146. MedinaC.A. FajardoA. CalderonA. AracenaM. Post-streptococcal uveitis: Case report.Ocul. Immunol. Inflamm.20192771086108910.1080/09273948.2018.1501493 30081680
     [Google Scholar]
  147. MillenderT.W. RellerL.B. MeekinsL.C. AfshariN.A. Streptococcal pharyngitis leading to corneal ulceration.Ocul. Immunol. Inflamm.201220214314410.3109/09273948.2011.649152 22360434
     [Google Scholar]
  148. ShuteC.L. ChakravarthyU. McAvoyC.E. Unilateral acute idiopathic maculopathy associated with streptococcal pharyngitis, a case report.Ocul. Immunol. Inflamm.20223061511151410.1080/09273948.2021.1880603 33793385
     [Google Scholar]
  149. MurrayR.C. ChennupatiS.K. Chronic streptococcal and non-streptococcal pharyngitis.Infect. Disord. Drug Targets201212428128510.2174/187152612801319311 22338589
     [Google Scholar]
  150. KatzB.Z. Streptococcal infections and exacerbation in pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection: A systematic review and meta-analysis.Pediatr. Infect. Dis. J.2019388e190e19110.1097/INF.0000000000002310 31306405
     [Google Scholar]
  151. SquintaniG. TinazziM. GambarinM. Post-streptococcal ‘complex’ movement disorders: Unusual concurrence of psychogenic and organic symptoms.J. Neurol. Sci.20102881-2687110.1016/j.jns.2009.10.004 19896680
     [Google Scholar]
  152. GarritsenF.M. KraagD.E. de GraafM. Guttate psoriasis triggered by perianal streptococcal infection.Clin. Exp. Dermatol.201742553653810.1111/ced.13129 28543851
     [Google Scholar]
  153. PfingstlerL.F. MaroonM. MowadC. Guttate psoriasis outcomes.Cutis2016972140144 26919501
     [Google Scholar]
  154. SalehD. TannerL.S. Guttate psoriasis.Treasure Island, FLStatPearls Publishing2022
     [Google Scholar]
  155. HansonV. KhalidS.N. RatmeyerG. SheikhA.B. Thyroid storm secondary to acute Streptococcus pyogenes pharyngitis.Proc. Bayl. Univ. Med. Cent.202235569169210.1080/08998280.2022.2077076 35991738
     [Google Scholar]
  156. CaladoG. LoureiroG. MachadoD. Streptococcal tonsillitis as a cause of urticaria.Allergol. Immunopathol.201240634134510.1016/j.aller.2011.06.008 21982399
     [Google Scholar]
  157. BarashJ. Group A streptococcal throat infection: To treat or not to treat?Acta Paediatr.200998343443610.1111/j.1651‑2227.2008.01177.x 19133868
     [Google Scholar]
  158. LeungA.K.C. BarankinB. LeongK.F. Henoch-Schönlein purpura in children: An updated review.Curr. Pediatr. Rev.202016426527610.2174/18756336MTA2lNDYc2 32384035
     [Google Scholar]
  159. RobsonW.L.M. LeungA.K.C. Acute rheumatic fever and Henoch-Schnlein purpura.Acta Paediatr.200392451310.1111/j.1651‑2227.2003.tb00591.x 12801126
     [Google Scholar]
  160. CannonJ.W. ZhungJ. BennettJ. The economic and health burdens of diseases caused by group A Streptococcus in New Zealand.Int. J. Infect. Dis.202110317618110.1016/j.ijid.2020.11.193 33278622
     [Google Scholar]
  161. MillerK.M. CarapetisJ.R. Van BenedenC.A. The global burden of sore throat and group A Streptococcus pharyngitis: A systematic review and meta-analysis.EClinicalMedicine20224810145810.1016/j.eclinm.2022.101458 35706486
     [Google Scholar]
  162. PfohE. WesselsM.R. GoldmannD. LeeG.M. Burden and economic cost of group A streptococcal pharyngitis.Pediatrics2008121222923410.1542/peds.2007‑0484 18245412
     [Google Scholar]
  163. Del MarC.B. GlasziouP.P. SpinksA.B. Antibiotics for sore throat.Cochrane Database Syst. Rev.20064CD00002310.1002/14651858.CD000023.pub3 17054126
     [Google Scholar]
  164. RandolphM.F. GerberM.A. DeMeoK.K. WrightL. Effect of antibiotic therapy on the clinical course of streptococcal pharyngitis.J. Pediatr.1985106687087510.1016/S0022‑3476(85)80228‑6 3923180
     [Google Scholar]
  165. SpinksA. GlasziouP.P. Del MarC.B. Antibiotics for sore throat.Cochrane Libr.2013201311CD00002310.1002/14651858.CD000023.pub4 24190439
     [Google Scholar]
  166. Van BrusselenD. VliegheE. SchelstraeteP. Streptococcal pharyngitis in children: To treat or not to treat?Eur. J. Pediatr.2014173101275128310.1007/s00431‑014‑2395‑2 25113742
     [Google Scholar]
  167. LinderJ.A. StaffordR.S. Antibiotic treatment of adults with sore throat by community primary care physicians: A national survey, 1989-1999.JAMA2001286101181118610.1001/jama.286.10.1181 11559262
     [Google Scholar]
  168. NeunerJ.M. HamelM.B. PhillipsR.S. BonaK. AronsonM.D. Diagnosis and management of adults with pharyngitis. A cost-effectiveness analysis.Ann. Intern. Med.2003139211312210.7326/0003‑4819‑139‑2‑200307150‑00011 12859161
     [Google Scholar]
  169. BaltimoreR.S. Re-evaluation of antibiotic treatment of streptococcal pharyngitis.Curr. Opin. Pediatr.2010221778210.1097/MOP.0b013e32833502e7 19996970
     [Google Scholar]
  170. BaltimoreR.S. Commentary on ‘Different antibiotic treatments for group A streptococcal pharyngitis (Review)’.Evid. Based Child Health201271848510.1002/ebch.1807 32313520
     [Google Scholar]
  171. MartinJ.M. The mysteries of streptococcal pharyngitis.Curr. Treat. Options Pediatr.20151218018910.1007/s40746‑015‑0013‑9 26146604
     [Google Scholar]
  172. van DrielM.L. De SutterA.I. KeberN. HabrakenH. ChristiaensT. Different antibiotic treatments for group A streptococcal pharyngitis.Cochrane Database Syst. Rev.20134CD00440610.1002/14651858.CD004406.pub3 23633318
     [Google Scholar]
  173. RimoinA.W. HoffN.A. Fischer WalkerC.L. Treatment of streptococcal pharyngitis with once-daily amoxicillin versus intramuscular benzathine penicillin G in low-resource settings: A randomized controlled trial.Clin Pediatr201150653554210.1177/0009922810394838 21317198
     [Google Scholar]
  174. RegoliM. ChiappiniE. BonsignoriF. GalliL. de MartinoM. Update on the management of acute pharyngitis in children.Ital. J. Pediatr.20113711010.1186/1824‑7288‑37‑10 21281502
     [Google Scholar]
  175. AndrewsM. CondrenM. Once-daily amoxicillin for pharyngitis.J. Pediatr. Pharmacol. Ther.201015424424810.5863/1551‑6776‑15.4.244 22477812
     [Google Scholar]
  176. LennonD.R. FarrellE. MartinD.R. StewartJ.M. Once-daily amoxicillin versus twice-daily penicillin V in group A -haemolytic streptococcal pharyngitis.Arch. Dis. Child.200893647447810.1136/adc.2006.113506 18337284
     [Google Scholar]
  177. LennonD. KerdemelidisM. ArrollB. SharpeN. Once-daily amoxicillin for Group A Streptococcal (GAS) sore throat as the other first-line option: A clarification of the NZ sore throat guidelines.N. Z. Med. J.20111241338116119 21946973
     [Google Scholar]
  178. NakaoA. HisataK. FujimoriM. MatsunagaN. KomatsuM. ShimizuT. Amoxicillin effect on bacterial load in group A streptococcal pharyngitis: Comparison of single and multiple daily dosage regimens.BMC Pediatr.201919120510.1186/s12887‑019‑1582‑8 31226961
     [Google Scholar]
  179. BrookI. GoberA.E. Rate of eradication of group A beta-hemolytic streptococci in children with pharyngo-tonsillitis by amoxicillin and cefdinir.Int. J. Pediatr. Otorhinolaryngol.200973575775910.1016/j.ijporl.2009.02.004 19285734
     [Google Scholar]
  180. CaseyJ.R. PichicheroM.E. Meta-analysis of cephalosporins versus penicillin for treatment of group A streptococcal tonsillopharyngitis in adults.Clin. Infect. Dis.200438111526153410.1086/392496 15156437
     [Google Scholar]
  181. HobanD.J. NautaJ. Clinical and bacteriological impact of clarithromycin in streptococcal pharyngitis: Findings from a meta-analysis of clinical trials.Drug Des. Devel. Ther.2019133551355810.2147/DDDT.S205820 31802844
     [Google Scholar]
  182. CaseyJ.R. PichicheroM.E. Higher dosages of azithromycin are more effective in treatment of group A streptococcal tonsillopharyngitis.Clin. Infect. Dis.200540121748175510.1086/430307 15909262
     [Google Scholar]
  183. PetrelliD. Di LucaM.C. PrennaM. BernaschiP. RepettoA. VitaliL.A. Characterization of levofloxacin non-susceptible clinical Streptococcus pyogenes isolated in the central part of Italy.Eur. J. Clin. Microbiol. Infect. Dis.201433224124410.1007/s10096‑013‑1950‑5 24002218
     [Google Scholar]
  184. LoganL.K. McAuleyJ.B. ShulmanS.T. Macrolide treatment failure in streptococcal pharyngitis resulting in acute rheumatic fever.Pediatrics20121293e798e80210.1542/peds.2011‑1198 22311996
     [Google Scholar]
  185. LinJ.N. ChangL.L. LaiC.H. High prevalence of fluoroquinolone-nonsusceptible Streptococcus pyogenes emm12 in Taiwan.Diagn. Microbiol. Infect. Dis.201583218719210.1016/j.diagmicrobio.2015.06.018 26234479
     [Google Scholar]
  186. PalmieriC. VecchiM. LittauerP. SundsfjordA. VaraldoP.E. FacinelliB. Clonal spread of macrolide- and tetracycline-resistant [erm(A) tet(O)] emm77 Streptococcus pyogenes isolates in Italy and Norway.Antimicrob. Agents Chemother.200650124229423010.1128/AAC.00943‑06 17043129
     [Google Scholar]
  187. RichterS.S. HeilmannK.P. BeekmannS.E. Macrolide-resistant streptococcus pyogenes in the united states, 2002-2003.Clin. Infect. Dis.200541559960810.1086/432473 16080080
     [Google Scholar]
  188. Van HeirstraetenL. LetenG. LammensC. GoossensH. Malhotra-KumarS. Increase in fluoroquinolone non-susceptibility among clinical Streptococcus pyogenes in Belgium during 2007-10.J. Antimicrob. Chemother.201267112602260510.1093/jac/dks281 22815354
     [Google Scholar]
  189. SakataH. Comparative study of 5-day cefcapene-pivoxil and 10-day amoxicillin or cefcapene-pivoxil for treatment of group A streptococcal pharyngitis in children.J. Infect. Chemother.200814320821210.1007/s10156‑008‑0597‑0 18574656
     [Google Scholar]
  190. Salinas SalvadorB. Moreno SánchezA. Carmen MarcénG. Retrospective study on the effectiveness and safety of the shortened 5- to 7-day antibiotic regimen for acute streptococcal pharyngotonsillitis compared to the classic 10-day regimen.An. Pediatr.202297639840410.1016/j.anpede.2022.07.005
     [Google Scholar]
  191. SchaadU.B. KellerhalsP. AltweggM. Azithromycin versus penicillin V for treatment of acute group A streptococcal pharyngitis.Pediatr. Infect. Dis. J.200221430430810.1097/00006454‑200204000‑00009 12075761
     [Google Scholar]
  192. TellD. TyrstrupM. EdlundC. Clinical course of pharyngotonsillitis with group A streptococcus treated with different penicillin V strategies, divided in groups of Centor Score 3 and 4: A prospective study in primary care.BMC Infect. Dis.202222184010.1186/s12879‑022‑07830‑4 36368940
     [Google Scholar]
  193. WightmanS. A 5-day course of penicillin V may be an effective treatment for streptococcal pharyngitis.Arch Dis Child Educ Pract Ed20201065edpract-2019-31874010.1136/archdischild‑2019‑318740 32198212
     [Google Scholar]
  194. AltamimiS. KhalilA. KhalaiwiK.A. MilnerR.A. PusicM.V. Al OthmanM.A. Short-term late-generation antibiotics versus longer term penicillin for acute streptococcal pharyngitis in children.Cochrane Libr.20128CD00487210.1002/14651858.CD004872.pub3 22895944
     [Google Scholar]
  195. KimS. Optimal Diagnosis and treatment of group A streptococcal pharyngitis.Infect. Chemother.201547320220410.3947/ic.2015.47.3.202 26483997
     [Google Scholar]
  196. LlorC. BjerrumL. Short courses of penicillin for streptococcal pharyngitis are not supported by the evidence.Fam. Pract.201835222822910.1093/fampra/cmx126 29244068
     [Google Scholar]
  197. BarsengaS. MitikuH. TesfaT. ShumeT. Throat carriage rate, associated factors, and antimicrobial susceptibility pattern of group A Streptococcus among healthy school children in Jigjiga City, Eastern Ethiopia.BMC Pediatr.202222122710.1186/s12887‑022‑03294‑2 35473515
     [Google Scholar]
  198. DeMuriG.P. WaldE.R. The group A streptococcal carrier state reviewed: Still an enigma.J. Pediatric Infect. Dis. Soc.20143433634210.1093/jpids/piu030 26625454
     [Google Scholar]
  199. OliverJ. Malliya WaduE. PierseN. Group A Streptococcus pharyngitis and pharyngeal carriage: A meta-analysis.PLoS Negl. Trop. Dis.2018123e000633510.1371/journal.pntd.0006335 29554121
     [Google Scholar]
  200. RickA.M. ZaheerH.A. MartinJ.M. Clinical features of group A streptococcus in children with pharyngitis: Carriers versus acute infection.Pediatr. Infect. Dis. J.202039648348810.1097/INF.0000000000002602 32040013
     [Google Scholar]
  201. van DrielM.L. De SutterA.I.M. HabrakenH. ThorningS. ChristiaensT. Different antibiotic treatments for group A streptococcal pharyngitis.Cochrane Libr.201699CD00440610.1002/14651858.CD004406.pub4 27614728
     [Google Scholar]
  202. IvaskaL. NiemeläJ. Gröndahl-Yli-HannukselaK. Detection of group A streptococcus in children with confirmed viral pharyngitis and antiviral host response.Eur. J. Pediatr.2022181124059406510.1007/s00431‑022‑04633‑2 36163516
     [Google Scholar]
  203. WaldER Tonsillectomy and/or adenoidectomy in children: Indications and contraindications.UpToDate.
     [Google Scholar]
  204. LeungA.K.C. HonK.L.E. RobsonW.L.M. Atopic dermatitis.Adv. Pediatr.200754124127310.1016/j.yapd.2007.03.013 17918474
     [Google Scholar]
  205. SteadW. Group Symptomatic treatment of acute pharyngitis in adults. UpToDate.
     [Google Scholar]
  206. WonnemannM. HelmI. Stauss-GraboM. Lidocaine 8 mg sore throat lozenges in the treatment of acute pharyngitis. A new therapeutic option investigated in comparison to placebo treatment.Arzneimittelforschung2011571168969710.1055/s‑0031‑1296669 18193690
     [Google Scholar]
  207. AspleyS. ShephardA. SchachtelE. SannerK. SavinoL. SchachtelB. Efficacy of flurbiprofen 8.75 mg lozenge in patients with a swollen and inflamed sore throat.Curr. Med. Res. Opin.20163291529153810.1080/03007995.2016.1187119 27146963
     [Google Scholar]
  208. BlagdenM. ChristianJ. MillerK. CharlesworthA. Multidose flurbiprofen 8.75 mg lozenges in the treatment of sore throat: A randomised, double-blind, placebo-controlled study in UK general practice centres.Int. J. Clin. Pract.20025629510010.1111/j.1742‑1241.2002.tb11204.x 11926713
     [Google Scholar]
  209. BouroubiA. DonazzoloY. DonathF. Pain relief of sore throat with a new anti-inflammatory throat lozenge, ibuprofen 25 mg: A randomised, double-blind, placebo-controlled, international phase III study.Int. J. Clin. Pract.2017719e1296110.1111/ijcp.12961 28869722
     [Google Scholar]
  210. BuchholzV. LeuwerM. AhrensJ. FoadiN. KrampflK. HaeselerG. Topical antiseptics for the treatment of sore throat block voltage-gated neuronal sodium channels in a local anaesthetic-like manner.Naunyn Schmiedebergs Arch. Pharmacol.2009380216116810.1007/s00210‑009‑0416‑x 19367399
     [Google Scholar]
  211. ChrubasikS. BeimeB. MagoraF. Efficacy of a benzocaine lozenge in the treatment of uncomplicated sore throat.Eur. Arch. Otorhinolaryngol.2012269257157710.1007/s00405‑011‑1802‑9 22015737
     [Google Scholar]
  212. CingiC. SonguM. UralA. YildirimM. ErdogmusN. BalC. Effects of chlorhexidine/benzydamine mouth spray on pain and quality of life in acute viral pharyngitis: A prospective, randomized, double-blind, placebo-controlled, multicenter study.Ear Nose Throat J.20108911546549 21086279
     [Google Scholar]
  213. CingiC. SonguM. UralA. Effect of chlorhexidine gluconate and benzydamine hydrochloride mouth spray on clinical signs and quality of life of patients with streptococcal tonsillopharyngitis: Multicentre, prospective, randomised, double-blinded, placebo-controlled study.J. Laryngol. Otol.2011125662062510.1017/S0022215111000065 21310101
     [Google Scholar]
  214. MeyC. PeilH. KölschS. BubeckJ. VixJ.M. Efficacy and safety of ambroxol lozenges in the treatment of acute uncomplicated sore throat. EBM-based clinical documentation.Arzneimittelforschung2011581155756810.1055/s‑0031‑1296557 19137906
     [Google Scholar]
  215. FischerJ. PschornU. VixJ.M. Efficacy and tolerability of ambroxol hydrochloride lozenges in sore throat. Randomised, double-blind, placebo-controlled trials regarding the local anaesthetic properties.Arzneimittelforschung201152425626310.1055/s‑0031‑1299889 12040968
     [Google Scholar]
  216. McNallyD. SimpsonM. MorrisC. ShephardA. GoulderM. Rapid relief of acute sore throat with AMC/DCBA throat lozenges: Randomised controlled trial.Int. J. Clin. Pract.201064219420710.1111/j.1742‑1241.2009.02230.x 19849767
     [Google Scholar]
  217. McNallyD. ShephardA. FieldE. Randomised, double-blind, placebo-controlled study of a single dose of an amylmetacresol/2,4-dichlorobenzyl alcohol plus lidocaine lozenge or a hexylresorcinol lozenge for the treatment of acute sore throat due to upper respiratory tract infection.J. Pharm. Pharm. Sci.201215228129410.18433/J31309 22579007
     [Google Scholar]
  218. PalmJ. FuchsK. StammerH. Schumacher-StimpflA. MildeJ. Efficacy and safety of a triple active sore throat lozenge in the treatment of patients with acute pharyngitis: Results of a multi-centre, randomised, placebo-controlled, double-blind, parallel-group trial (DoriPha).Int. J. Clin. Pract.20187212e1327210.1111/ijcp.13272 30329199
     [Google Scholar]
  219. SchachtelB. AspleyS. ShephardA. Onset of action of a lozenge containing flurbiprofen 8.75 mg: A randomized, double-blind, placebo-controlled trial with a new method for measuring onset of analgesic activity.Pain2014155242242810.1016/j.pain.2013.11.001 24231654
     [Google Scholar]
  220. SchachtelB. ShephardA. SchachtelE. SheaT. SmithA. TselentiE. Evidence of the efficacy of flurbiprofen 8.75 mg lozenges for patients receiving antibiotics for laboratory-confirmed streptococcal pharyngitis.Ear Nose Throat J.2021145561321102575410.1177/01455613211025754 34261371
     [Google Scholar]
  221. SchutzA. GundH.J. PschornU. Local anaesthetic properties of ambroxol hydrochloride lozenges in view of sore throat. Clinical proof of concept.Arzneimittelforschung201152319419910.1055/s‑0031‑1299879 11963647
     [Google Scholar]
  222. ShephardA. SmithG. AspleyS. SchachtelB.P. Randomised, double-blind, placebo-controlled studies on flurbiprofen 8.75 mg lozenges in patients with/without group A or C streptococcal throat infection, with an assessment of clinicians’ prediction of ‘strep throat’.Int. J. Clin. Pract.2015691597110.1111/ijcp.12536 25296661
     [Google Scholar]
  223. ThomasM. Del MarC. GlasziouP. How effective are treatments other than antibiotics for acute sore throat?Br. J. Gen. Pract.200050459817820 11127175
     [Google Scholar]
  224. WadeA.G. MorrisC. ShephardA. CrawfordG.M. GoulderM.A. A multicentre, randomised, double-blind, single-dose study assessing the efficacy of AMC/DCBA Warm lozenge or AMC/DCBA Cool lozenge in the relief of acute sore throat.BMC Fam. Pract.2011121610.1186/1471‑2296‑12‑6 21332976
     [Google Scholar]
  225. WattE.E. BettsB.A. KoteyF.O. Menthol shares general anesthetic activity and sites of action on the GABAA receptor with the intravenous agent, propofol.Eur. J. Pharmacol.20085901-312012610.1016/j.ejphar.2008.06.003 18593637
     [Google Scholar]
  226. JiangX. LinA. LiS. Effects of artificial honey and epigallocatechin-3-gallate on streptococcus pyogenes.BMC Microbiol.202222120710.1186/s12866‑022‑02611‑0 36028794
     [Google Scholar]
  227. OtrębaM. MarekŁ. TyczyńskaN. StojkoJ. Rzepecka-StojkoA. Bee venom, honey, and Royal jelly in the treatment of bacterial infections of the oral cavity: A review.Life20211112131110.3390/life11121311 34947842
     [Google Scholar]
  228. Abdulraheem Al-KafaweenM. Al-JamalH.A. Mohd HilmiA.B. ElsahoryiN.A. JaffarN. Khairi ZahriM. Antibacterial properties of selected Malaysian Tualang honey against Pseudomonas aeruginosa and Streptococcus pyogenes.Iran. J. Microbiol.202012656557610.18502/ijm.v12i6.5031 33613911
     [Google Scholar]
  229. Al-kafaweenM.A. Al-JamalH.A.N. A comparative study of antibacterial and antivirulence activities of four selected honeys to Manuka honey.Iran. J. Microbiol.202214223825110.18502/ijm.v14i2.9193 35765547
     [Google Scholar]
  230. MaddocksS.E. LopezM.S. RowlandsR.S. CooperR.A. Manuka honey inhibits the development of Streptococcus pyogenes biofilms and causes reduced expression of two fibronectin binding proteins.Microbiology2012158378179010.1099/mic.0.053959‑0 22294681
     [Google Scholar]
  231. MaddocksS.E. JenkinsR.E. RowlandsR.S. PurdyK.J. CooperR.A. Manuka honey inhibits adhesion and invasion of medically important wound bacteria in vitro.Future Microbiol.20138121523153610.2217/fmb.13.126 24266353
     [Google Scholar]
  232. MoussaA. NoureddineD. MohamedH.S. AbdelmelekM. SaadA. Antibacterial activity of various honey types of algeria against staphylococcus aureus and streptococcus pyogenes.Asian Pac. J. Trop. Med.201251077377610.1016/S1995‑7645(12)60141‑2 23043914
     [Google Scholar]
  233. HuangY. WuT. ZengL. LiS. Chinese medicinal herbs for sore throat.Cochrane Libr.20123CD00487710.1002/14651858.CD004877.pub3 22419300
     [Google Scholar]
  234. AbachiS. MacéS. LeeS. RupasingheH.P.V. Cranberry and sumac extracts exhibit antibacterial and anti-adhesive effects against Streptococcus pyogenes.J. Med. Food202225442643410.1089/jmf.2021.0047 35076261
     [Google Scholar]
  235. AdilM. KhanR. RupasingheH.P.V. Application of medicinal plants as a source for therapeutic agents against Streptococcus pyogenes infections.Curr. Drug Metab.201819869570310.2174/1389200219666180329150551 29595103
     [Google Scholar]
  236. BrinckmannJ. SigwartH. van Houten TaylorL. Safety and efficacy of a traditional herbal medicine (Throat Coat) in symptomatic temporary relief of pain in patients with acute pharyngitis: A multicenter, prospective, randomized, double-blinded, placebo-controlled study.J. Altern. Complement. Med.20039228529810.1089/10755530360623400 12804082
     [Google Scholar]
  237. WijesundaraN.M. RupasingheH.P.V. Essential oils from Origanum vulgare and Salvia officinalis exhibit antibacterial and anti-biofilm activities against Streptococcus pyogenes.Microb. Pathog.201811711812710.1016/j.micpath.2018.02.026 29452197
     [Google Scholar]
  238. WijesundaraN.M. RupasingheH.P.V. Herbal tea for the management of pharyngitis: Inhibition of Streptococcus pyogenes growth and biofilm formation by herbal infusions.Biomedicines2019736310.3390/biomedicines7030063 31450579
     [Google Scholar]
  239. WijesundaraN. RupasingheH. Bactericidal and anti-biofilm activity of ethanol extracts derived from selected medicinal plants against Streptococcus pyogenes.Molecules2019246116510.3390/molecules24061165 30909644
     [Google Scholar]
  240. WijesundaraN.M. LeeS.F. ChengZ. DavidsonR. LangelaanD.N. RupasingheH.P.V. Bactericidal activity of Carvacrol against Streptococcus pyogenes involves alteration of membrane fluidity and integrity through interaction with membrane phospholipids.Pharmaceutics20221410199210.3390/pharmaceutics14101992 36297428
     [Google Scholar]
  241. Di PierroF. DonatoG. FomiaF. Preliminary pediatric clinical evaluation of the oral probiotic Streptococcus salivarius K12 in preventing recurrent pharyngitis and/or tonsillitis caused by Streptococcus pyogenes and recurrent acute otitis media.Int. J. Gen. Med.2012599199710.2147/IJGM.S38859 23233809
     [Google Scholar]
  242. Di PierroF. AdamiT. RapacioliG. GiardiniN. StreitbergerC. Clinical evaluation of the oral probiotic Streptococcus salivarius K12 in the prevention of recurrent pharyngitis and/or tonsillitis caused by Streptococcus pyogenes in adults.Expert Opin. Biol. Ther.201313333934310.1517/14712598.2013.758711 23286823
     [Google Scholar]
  243. Di PierroF. ColomboM. ZanvitA. RissoP. RottoliA. Use of Streptococcus salivarius K12 in the prevention of streptococcal and viral pharyngotonsillitis in children.Drug Healthc. Patient Saf.20146152010.2147/DHPS.S59665 24600248
     [Google Scholar]
  244. Di PierroF. ColomboM. GiulianiM.G. Effect of administration of Streptococcus salivarius K12 on the occurrence of streptococcal pharyngo-tonsillitis, scarlet fever and acute otitis media in 3 years old children.Eur. Rev. Med. Pharmacol. Sci.2016202146014606 27874935
     [Google Scholar]
  245. Di PierroF. ColomboM. ZanvitA. RottoliA.S. Positive clinical outcomes derived from using Streptococcus salivarius K12 to prevent streptococcal pharyngotonsillitis in children: A pilot investigation.Drug Healthc. Patient Saf.20168778110.2147/DHPS.S117214 27920580
     [Google Scholar]
  246. Di PierroF. RissoP. PoggiE. Use of Streptococcus salivarius K12 to reduce the incidence of pharyngo-tonsillitis and acute otitis media in children: A retrospective analysis in not-recurrent pediatric subjects.Minerva Pediatr.201870324024510.23736/S0026‑4946.18.05182‑4 29322750
     [Google Scholar]
  247. Di PierroF. Assessment of efficacy of BLIS-producing probiotic K12 for the prevention of Group A streptococcus pharyngitis: A short communication.Probiotics Antimicrob. Proteins201911133233410.1007/s12602‑018‑9398‑7 29464500
     [Google Scholar]
  248. DoyleH. PierseN. TiatiaR. WilliamsonD. BakerM. CraneJ. Effect of oral probiotic Streptococcus salivarius K12 on Group A streptococcus pharyngitis: A pragmatic trial in schools.Pediatr. Infect. Dis. J.201837761962310.1097/INF.0000000000001847 29189607
     [Google Scholar]
  249. GregoriG. RighiO. RissoP. Reduction of group A beta-hemolytic streptococcus pharyngo-tonsillar infections associated with use of the oral probiotic Streptococcus salivarius K12: A retrospective observational study.Ther. Clin. Risk Manag.201612879210.2147/TCRM.S96134 26855579
     [Google Scholar]
  250. AndrejkoK. WhittlesL.K. LewnardJ.A. Health-economic value of vaccination against group A streptococcus in the United States.Clin. Infect. Dis.202274698399210.1093/cid/ciab597 34192307
     [Google Scholar]
  251. Di BenedettoR. ManciniF. CarducciM. Rational design of a glycoconjugate vaccine against group A streptococcus.Int. J. Mol. Sci.20202122855810.3390/ijms21228558 33202815
     [Google Scholar]
  252. BaumsC.G. KaimU. FuldeM. RamachandranG. GoetheR. Valentin-WeigandP. Identification of a novel virulence determinant with serum opacification activity in Streptococcus suis.Infect. Immun.200674116154616210.1128/IAI.00359‑06 17057090
     [Google Scholar]
  253. HuM.C. WallsM.A. StroopS.D. ReddishM.A. BeallB. DaleJ.B. Immunogenicity of a 26-valent group A streptococcal vaccine.Infect. Immun.20027042171217710.1128/IAI.70.4.2171‑2177.2002 11895984
     [Google Scholar]
  254. McNeilS.A. HalperinS.A. LangleyJ.M. Safety and immunogenicity of 26-valent group a streptococcus vaccine in healthy adult volunteers.Clin. Infect. Dis.20054181114112210.1086/444458 16163629
     [Google Scholar]
  255. SekuloskiS. BatzloffM.R. GriffinP. Evaluation of safety and immunogenicity of a group A streptococcus vaccine candidate (MJ8VAX) in a randomized clinical trial.PLoS One2018137e019865810.1371/journal.pone.0198658 29965967
     [Google Scholar]
  256. CastroS.A. DorfmuellerH.C. A brief review on Group A Streptococcus pathogenesis and vaccine development.R. Soc. Open Sci.20218320199110.1098/rsos.201991 33959354
     [Google Scholar]
  257. FischettiVA Vaccine approaches to protect against group A streptococcal pharyngitis.Microbiol Spectr2019737.3.210.1128/microbiolspec.GPP3‑0010‑201831111819
     [Google Scholar]
  258. GiffardP.M. TongS.Y.C. HoltD.C. RalphA.P. CurrieB.J. Concerns for efficacy of a 30-valent M-protein-based Streptococcus pyogenes vaccine in regions with high rates of rheumatic heart disease.PLoS Negl. Trop. Dis.2019137e000751110.1371/journal.pntd.0007511 31269021
     [Google Scholar]
  259. PasturalÉ. McNeilS.A. MacKinnon-CameronD. Safety and immunogenicity of a 30-valent M protein-based group a streptococcal vaccine in healthy adult volunteers: A randomized, controlled phase I study.Vaccine20203861384139210.1016/j.vaccine.2019.12.005 31843270
     [Google Scholar]
  260. BatemanE. MansourS. OkaforE. ArringtonK. HongB.Y. CervantesJ. Examining the efficacy of antimicrobial therapy in preventing the development of postinfectious glomerulonephritis: A systematic review and meta-analysis.Infect. Dis. Rep.202214217618310.3390/idr14020022 35314652
     [Google Scholar]
  261. ManessD.L. MartinM. MitchellG. Poststreptococcal illness: Recognition and management.Am. Fam. Physician2018978517522 29671499
     [Google Scholar]
  262. SainatoR.J. WeisseM.E. Poststreptococcal glomerulonephritis and antibiotics: A fresh look at old data.Clin Pediatr2019581101210.1177/0009922818793345 30095005
     [Google Scholar]
/content/journals/cpr/10.2174/1573396320666230726145436
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Group A β-hemolytic Streptococcal Pharyngitis: An Updated Review
Curr Pediatr Rev 21, 2 (2025); https://doi.org/10.2174/1573396320666230726145436
/content/journals/cpr/10.2174/1573396320666230726145436
/content/journals/cpr/10.2174/1573396320666230726145436
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  • Article Type:     Review Article
Keyword(s): Centor score; group A β-hemolytic Streptococcus; McIssac score; pharyngitis; strawberry tongue; Streptococcus pyogenes

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