Severe Acute Pharyngitis Caused by Group C Streptococcus
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Adult group C beta-hemolytic streptococcal pharyngitis has a prevalence of approximately 5%. It can present with a broad spectrum of severity.
We report a 30-year-old woman who presented with severe Group C streptococcal pharyngitis.
She presented with a 9-day history of progressive symptoms, including fever, sore throat, neck swelling, and recent onset of hoarseness. In the 9 days before the emergency room (ER) presentation, the patient had visited the ER twice complaining of a sore throat. At both visits, the physicians performed rapid antigen strep testing. Each time her test was negative and the physicians recommended symptomatic therapy. Her symptoms continued to worsen leading to her repeat presentation. At this time she had severe pharyngitis with markedly enlarged tonsils. Neck CT excluded peritonsillar abscess. Rapid strep testing was again negative, but her throat culture grew group C beta-hemolytic streptococcus.
This presentation illustrates the importance of a systematic approach to evaluating patients with negative rapid strep tests and worsening pharyngitis.
Potential Financial Conflicts of Interest:
- Centor, R, Witherspoon, J, Dalton, H, Brody, C, Link, K (1981) The Diagnosis of Strep Throat in Adults in the Emergency Room. Med Dec Making 1: pp. 239-246 CrossRef
- Bisno, A, Gerber, M, Gwaltney, J (2002) Practice Guidelines for the Diagnosis and Management of Group A Streptococcal Pharyngitis. Clin Infect Dis 35: pp. 113-125 CrossRef
- Gonzales, R, Bartlett, J, Besser, R (2001) Principles of Appropriate Use for Treatment of Acute Respiratory Tract Infections in Adults: Background, Specific Aims, and Methods. Ann Intern Med 134: pp. 479-486
- Gerber, M, Shulman, S (2004) Rapid Diagnosis of Pharyngitis Caused by Group A Streptococci. Clin Microbiol Rev 17: pp. 571-580 CrossRef
- Ochoa, R, Goldstein, J, Rubin, R (2005) Clinicopathological Conference: Lemierre’s Syndrome. Acad Emerg Med 12: pp. 152-157 CrossRef
- Meier, F, Centor, R, Graham, L, Dalton, H (1990) Clinical and Microbiological Evidence for Endemic Pharyngitis Among Adults due to Group C Streptococci. Arch Intern Med 150: pp. 825-829 CrossRef
- Turner, J, Hayden, F, Lobo, M, Ramirez, C, Murren, D (1997) Epidemiologic Evidence for Lancefield Group C Beta-hemolytic Streptococci as a Cause of Exudative Pharyngitis in College Students. J Clin Microbiol 35: pp. 1-4
- Lindboek, M, Hoiby, E, Lermark, G, Steinsholt, I, Hjortdahl, P (2005) Clinical Symptoms and Signs in Sore Throat Patients with Large Colony Variant Beta-haemolytic Streptococci Groups C or G Versus Group A. Br J Gen Pract 55: pp. 615-619
- Zwart, S, Sachs, A, Ruijs, G, Gubbels, J, Hoes, A, Melker, R (2000) Penicillin for acute sore throat: randomized double blind trial of seven days versus three days treatment or placebo in adults. Br Med J 320: pp. 150-154 CrossRef
- Johnsen, T, Katholm, M, Stangerup, S (1984) Otolaryngological Complications in Infectious Mononucleosis. Laryngol Otol 98: pp. 999-1001
- Stevenson, D, Webster, G, Stewart, I (1992) Acute Tonsillectomy in the Management of Infectious Mononucleosis. J Laryngol Otol 106: pp. 989-991 CrossRef
- Severe Acute Pharyngitis Caused by Group C Streptococcus
Journal of General Internal Medicine
Volume 22, Issue 2 , pp 272-274
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- group C beta
- streptococcal pharyngitis
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- Author Affiliations
- 1. Department of Family Practice, University of Alabama, Huntsville Regional Medical Campus, Huntsville, AL, USA
- 2. Department of Internal Medicine, University of Alabama, FOT 720, 1530 3rd Avenue S, Birmingham, AL, 35294-3407, USA