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Group A streptococcal pharyngitis
  1. Lok-Yee Joyce Li1,2,
  2. Shin-Yi Wang3,
  3. Cheng-Yu Tsai4 and
  4. Cheng-Jung Wu5,6
  1. 1Department of Medicine, Shin Kong Wu Ho Su Memorial Hospital, Taipei, Taiwan
  2. 2School of Medicine, Taipei Medical University College of Medicine, Taipei, Taiwan
  3. 3National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
  4. 4Department of Civil and Environmental Engineering, Imperial College London, London, UK
  5. 5Department of Otolaryngology, Taipei Medical University Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
  6. 6National Yang Ming Chiao Tung University, Hsinchu, Taiwan
  1. Correspondence to Dr Cheng-Jung Wu; B101090126{at}

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A 6-year-old boy presented to the emergency department with severe throat pain and raging fever for 1 day. The patient was unable to eat solids foods because of pain. On physical examination, cervical node lymphadenopathy, a swollen uvula and palatal petechiae were noted (figure 1). The rapid strep test is done to help quickly determine whether a sore throat is caused by a streptococcal infection. The result of a throat culture is compatible with the diagnosis of group A streptococcal pharyngitis. The patient was treated with penicillin and topical analgesia. The primary reason to treat this self-limited illness with antibiotics is to reduce the risk of complications such as rheumatic fever, meningitis, endocarditis and retropharyngeal abscess.1–3 Antibiotic therapy also reduces the risk of suppurative complications of streptococcal infection.4 A Cochrane review of randomised, placebo-controlled trials showed that antibiotic therapy significantly reduced the risks of acute otitis media and peritonsillar abscess.5 Treatment with antibiotics is effective if given within 9 days of the onset of symptoms.

Figure 1

Palatal petechiae were noted.

Learning points

  • Treat this self-limited illness with antibiotics which could reduce the risk of complications such as rheumatic fever, meningitis, endocarditis and retropharyngeal abscess.

  • Common symptoms include cervical node lymphadenopathy, a swollen uvula and palatal petechiae.

Ethics statements

Patient consent for publication



  • Contributors C-JW and L-YJL performed the experiments. L-YJL, S-YW and C-YT contributed reagents/materials/analysis tools. L-YJL wrote the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.