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- Inflammation of the pharynx most commonly caused by acute viral infection
- Group A streptococcus is a focus due to its potential for preventable rheumatic sequelae.
- Chronic low-grade symptoms usually are related to reflux disease or vocal abuse.
- System(s) affected: Respiratory
- Synonym(s): Sore throat; Tonsillitis; Streptococcal throat
- Estimated 30 million cases diagnosed yearly
- 12–25% of all sore throats are thought to prompt visits to physicians.
- Predominant age: All age groups
- Predominant sex: Male = Female
- Respiratory infections account for 38% of the 129 million visits per year to physicians in the US. This is ~200 visits to a physician per 1,000 population in the US annually (1).
- The etiology of the vast majority of these infections is viral.
- Group A streptococcus is the most common bacterial cause of acute pharyngitis, accounting for ~15–30% of cases in children and 5–10% of cases in adults.
- Rheumatic fever is rare in the US; 112 cases reported to the CDC in 1994, the last year this was a reportable disease.
Rheumatic fever has its greatest incidence in children aged 5–18 years, but is currently a rare sequel of streptococcal pharyngitis in the US.
Prevalence is quite variable in this acute, self-limited disease of short duration.
- Epidemics of group A β-hemolytic streptococcal disease occur.
- Age (i.e., young people are more susceptible)
- Family history
- Close quarters, such as in new military recruits
- Excess alcohol consumption
- Receptive oral sex
- Diabetes mellitus
- Recent illness
Patients with a positive family history of rheumatic fever have a higher risk of rheumatic sequelae following an untreated group A β-hemolytic streptococcal infection.
Avoid contact with infected people.
- Acute, viral:
- Parainfluenza virus
- Herpes simplex virus
- Epstein-Barr virus (EBV) (mononucleosis)
- Acute, bacterial:
- Group A β-hemolytic streptococci <10% of adult pharyngitis
- Neisseria gonorrhoeae
- Corynebacterium diphtheriae (diphtheria)
- Haemophilus influenzae
- Moraxella (Branhamella) catarrhalis
- Groups C and G streptococcus, rarely
- More likely noninfectious
- Irritation from postnasal discharge of chronic allergic rhinitis or reflux
- Chemical irritation or smoking
- Neoplasms and vasculitides