Optimal Diagnosis and Treatment of Group A Streptococcal Pharyngitis

Group A streptococcus (GAS), or Streptococcus pyogenes, is the most common pathogen responsible for bacterial pharyngitis, which has the following characteristic clinical manifestations: fever, tender cervical lymphadenopathy, exudative pharyngeal discharge, and absence of common cold symptoms (cough, coryza, rhinorrhea, diarrhea, oral ulcer) [1, 2]. In addition to these Centor criteria, GAS pharyngitis has an acute onset, and is prevalent during winter and early spring in children between 5 and 15 years of age. Among the types of pharyngitis, GAS constitutes about 20-30% of cases in children and 5-10% of cases in adults [1, 2]. Although immunologic complications such as rheumatic fever and post-streptococcal glomerulonephritis are currently very rare in developed countries, GAS pharyngitis is still important due to its prevalence and emergence of antibiotic resistance.