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When Your Patient Has a Sore Throat
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½ÂÀÎ 2001.05.15  13:42:57
Æ®À§ÅÍ ÆäÀ̽ººÏ ¹ÌÅõµ¥ÀÌ ¿äÁò ³×À̹ö ±¸±Û msn
piratory obs- truction,fever and pharyngitis
.

Strep. Throat (S.T.)
¨ç Although many bacteria can cause pharyngitis, the most common and one of the most serious is group A beta-hemolytic streptococci(GABHS), the cause of ¡°strepthroat¡± GABHS is most likely to cause pharyngitis in the late winter and early spring. The cough and nasal congestion seen with rhinovirus is not common. Instead, the pat ient often complains of ancillary symptoms such as chills, fever (as high as 105¡Æ F), headache, nausea, vomiting, and abnominal pain. The patient may also exhibit scarlet fever, the appearance of a petechial rash that begins on the axillae. With the resolution of the rash, the skin may desquamate.
¨è Traditionally, GABHS has been thought to be found mostly in patients aged 6~12 years: however, recent research explored its occurrence in those aged 30~65years. Pharmacist should not rule out strep throat when adults complain of sore throat. Although GABHS induced pharyngitis usually resolves without sequelae, it can cause devastating consequen ces (e.g.,retropharyngeal abscess, peritonsillar abscess, or suppurative cervical ly mphadenitis). It can also produce acute rheumatic fever (in which the joints, heart, skin, CNS, and subcutaneous tissues all m ay be affected) and acute glomerulonephritis (producing gross hematuria, hypertension, edema and renal insufficiency)
¨é Patients suspected of having GABHS-in duced sore throat should be referred to a physician.
¨ê The ideal treatment is penicillin V 250mg three or four times daily for 10 days. This regimen prevents acute rheumatic fever and is unexpensive. Clarithromycin and azithromycin are broader-spectrum agents that usually are able to eliminate any causative bacteria in cases when GABHS is not the culprit.


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