September Week 2

Articles:

Pediatrics in Review: Group A Strep – 1998

NEJM Group A Strep article – 2011

Case:

A 6-year-old boy presents in September to CYAS with a 1-day history of sore throat, (though denies cough), fever and headache. On exam, he appears uncomfortable and is noted to have a temperature of 38.5C, bilateral cervical lymphadenopathy, and an exudative and erythematous posterior oropharynx. Of note, he just started kindergarten and there are several children at school with similar symptoms.

In what age range do children with GABHS pharyngitis generally present?

How do GABHS infections usually present in children less than 2yo?

What are the common signs and symptoms of a GABHS pharyngitis?

What symptoms would make you consider an alternate diagnosis?

What is the generally accepted specificity of rapid strep tests?

What is the first line treatment for GABHS pharyngitis? What if your patient has a severe allergy to penicillins and cephalosporins?

What are the reasons we treat GABHS infections? What are the potential complications of untreated GABHS infection?

Approximately what percentage of children are Strep carriers? 
 

Case by Dr. Monica Gill, PGY2