Make decisions on an individual basis, taking into account available testing, the severity of symptoms, the feasibility of arranging follow-up care, and the need for patients and their families to quickly return to their regular routine.
For patients with viral pharyngitis, care should be supportive, with antipyretics for pain and fever.
Some have also suggested that steroid use, dexamethasone in particular, may reduce pain and decrease symptom duration for both viral pharyngitis and streptococcal pharyngitis. This has been primarily shown in the adult population. In children, the length of symptoms has been shown to be minimally improved with adjunct steroid use; however, steroids might be considered in children with significant symptoms or discomfort. [11]
Refer to the primary care physician for follow-up care. For most patients, no specific diet is needed, but adequate fluid intake and hydration are of vital importance. Monitor the patient to prevent secondary dehydration. To limit the spread to other individuals who have not been exposed, the patient should avoid school and new contacts during the initial 24 hours after beginning antibiotic therapy for GABHS and until free of fever.
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Posterior pharynx with petechiae and exudates in a 12-year-old girl. Both the rapid antigen detection test and throat culture were positive for group A beta-hemolytic streptococci.
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Streptococcal pharyngitis. Note the redness and edema of the oropharynx and petechiae, or small red spots, on the soft palate caused by strep throat. Strep throat is caused by group A streptococcus bacteria. These bacteria are spread through direct contact with mucus from the nose or throat of persons who are infected or through contact with infected wounds or sores on the skin.
