27 - Pharyngitis

Acute pharyngitis is one of the most common illnesses for which children in the United States visit primary care providers; pediatricians make the diagnosis of acute pharyngitis, acute tonsillitis, or “strep throat” more than 7 million times annually. A partial list of the more common microorganisms that can cause acute pharyngitis is presented in Table 27-1. Most cases in children and adolescents are caused by viruses and are benign and self-limited. Group A β-hemolytic streptococcus (GAS, Streptococcus pyogenes) is the most important bacterial cause. Strategies for the diagnosis and treatment of pharyngitis in children and adolescents are directed at distinguishing the large group of patients with viral pharyngitis that would not benefit from antimicrobial therapy from the significantly smaller group of patients with GAS pharyngitis for whom antimicrobial therapy would be beneficial. Making this distinction is extremely important in attempting to minimize the unnecessary use of antibiotics in children and adolescents.