الفهرس 
Acute Sore Throat and GAS Infection: Epidemiology and ComplicationsOnly 14 pages are availabe for public view
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Abstract
treptococcus pyogenes (GAS) is a major cause of morbidity and mortality worldwide. GAS accounts for 20% to 40% of sore throat cases in children and 5% to 15% in adults.
In primary care, roughly, third of the patients with respiratory tract infections presents with sore throat and almost third of the antibiotics are prescribed for these infections.
Although GAS pharyngitis is a superficial infection in the throat, it can lead to various types of suppurative and non- suppurative complication. The suppurative sequelae include peritonsillar cellulitis abscess (quinsy), retropharyngeal, cervical lymphadenitis, sinusitis, acute otitis media and mastoiditis. On the other hand, the non-suppurative post-streptococcal diseases occur as an autoimmune inflammatory response to GAS infection affecting mainly heart and kidney causing acute rheumatic fever (ARF) and acute glomerulonephritis.
Antibiotic treatment of acute streptococcal sore throat can prevent acute rheumatic fever, however, presumptive antibiotic prescriptions to patients with streptococcal pharyngitis without relying on a valid clinical guidance or a diagnostic test can predispose to upsurge in the carrier state and in the rate of antibiotic-resistant strains of GAS.
Throat culture is the gold standard microbiological method for establishing the diagnosis of GAS pharyngitis; however the availability and feasibility of bacterial culture in clinical settings cannot be guaranteed, especially in regions with limited resources and higher incidences of post-infectious cardiac complications, as in many developing countries. In these regions, the use of clinical scoring systems can predict streptococcal throat infections and guide clinicians’ decisions on prescribing antibiotic for these infections.
The relevance of clinical prediction scores for determining which children with sore throat should undergo a lab detection test remains questionable. A formal comparisons of clinical prediction rules performance is needed to provide an informative evaluation and standardization of clinical outcomes.