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Diagnosis

Diagnosis of Group A Streptococcus

Acute pharyngitis is one of the most frequent illnesses for which primary care physicians are consulted. Although Group A Strep is the most common bacterial cause of acute pharyngitis, not all patients with this condition are infected by Group A Strep. While other forms of pharyngitis display the same symptoms, Group A Strep pharyngitis is the only commonly occurring form of acute pharyngitis for which antibiotic therapy is definitely indicated. Therefore, unless the physician is able to exclude Group A Strep on epidemiological and clinical grounds, a laboratory test should be performed for the bacteria.

Important, updated information on diagnostic tests and how to choose the ones for your facility

The most severe diseases caused by invasive Group A Strep are necrotizing fasciitis and STSS, so physicians should be alert for the signs and symptoms of both.

  • Early signs and symptoms of necrotizing fasciitis:
    • Severe pain and swelling, often rapidly increasing
    • Fever
    • Redness at a wound site
  • Early signs and symptoms of STSS:
    • Fever
    • Abrupt onset of generalized or localized severe pain, often in an arm or leg
    • Dizziness
    • Influenza-like syndrome
    • Confusion
    • A flat red rash over large areas of the body (only occurs in 10% of cases)2

IDSA 2012 Guidelines. Bisno, Alan et al. "Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America

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