What is the pathophysiology of group A beta-hemolytic streptococci (GABHS) pediatric pharyngitis?

Updated: Dec 11, 2018
  • Author: Harold K Simon, MD, MBA; Chief Editor: Russell W Steele, MD  more...
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Answer

GABHS is the primary organism of concern in most pediatric cases of pharyngitis because appropriate antibiotic therapy is effective and can eliminate the cardiac complications of rheumatic fever. More than 80 M-protein types of GABHS have been isolated. Serotypes 1, 3, 5, 6, 18, 19, and 24 are associated with rheumatic fever (and thus are referred to as rheumatogenic forms), whereas others, such as serotypes 49, 55, and 57, are associated with pyoderma and acute poststreptococcal glomerulonephritis.

GABHS pharyngitis is spread via respiratory droplets through close contact. It has an incubation period of 2-5 days.

A study found that in adolescents and young adults, Fusobacterium necrophorum pharyngitis was more common than group A beta-hemolytic streptococcal (GAS) pharyngitis. European data suggest that in patients aged 15 to 30 years, Fusobacterium necrophorum causes at least 10% of cases of pharyngitis. The study also observed that F. necrophorum was the primary cause of Lemierre syndrome in this age group. [3, 4]


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