Group A Strep Pharyngitis Transmission

Transmission and Incubation Period

• Group A strep pharyngitis is primarily spread through direct person-to-person transmission via respiratory droplets, contact with secretions, or saliva and nasal secretions from an infected person.
• Incubation period is approximately 2-5 days.

Diagnosis

• History and clinical examination can diagnose viral pharyngitis when clear viral symptoms are present.
• Rapid antigen detection test (RADT) or throat culture is required to confirm group A strep pharyngitis.
• RADTs have high specificity for group A strep, but varying sensitivities compared to throat culture.
• Throat culture is the gold standard diagnostic test.

Treatment

• Goals: symptom reduction, prevention of complications (suppurative and nonsuppurative), and prevention of transmission.
• Antibiotics (penicillin V or amoxicillin) shorten symptom duration by 16-24 hours and prevent rheumatic fever.
• Cephalosporins, macrolides, and clindamycin can also be used.
• Resistance may develop during treatment with azithromycin and clarithromycin.

Enhancing Healthcare Team Outcomes

• Follow-up is required to monitor patient progress and provide education on antibiotic use, hand hygiene, and personal hygiene.
• Patients should be told not to use antibiotics empirically as the cause is often viral.
• Immunization against the flu virus and diphtheria is recommended.

Outcomes

• Most pharyngitis cases recover spontaneously within 7-10 days.
• Failures may occur due to antibiotic resistance, lack of patient compliance, or if the cause is bacterial and antibiotics were not prescribed.
• Complications occur in less than 1% of patients, including otitis media, pneumonia, nephritis, and meningitis.

Sinusitis

• Sinusitis is swelling of the sinuses, usually caused by an infection, and typically clears up on its own within 4 weeks.
• Medicines can help if it's taking a long time to go away.
• Azithromycin or clindamycin can be used in patients with a history of anaphylaxis to penicillin.

Differential Diagnosis

• Airway obstruction from any cause
• Allergic rhinitis
• Cancer of the head and neck
• Gastroesophageal reflux disease
• Peritonsillar abscess
• Diphtheria
• Epiglottitis
• Herpes simplex virus
• Mononucleosis

Complications

• Epiglottitis
• Otitis media
• Mastoiditis
• Sinusitis
• Acute rheumatic fever
• Post-streptococcal glomerulonephritis
• Toxic shock syndrome

Learn about the transmission and incubation period of group A strep pharyngitis, a contagious infection that can be spread through direct person-to-person contact or respiratory droplets.