Acute tonsillopharyngitis of streptococcal etiology in children: the importance of rapid diagnosis

Acute tonsillopharyngitis of streptococcal etiology in children: the importance of rapid diagnosis

I.N. Zakharova¹, I.V. Berezhnaya¹, I.D. Maykova², N.F. Dubovets², D.K. Dmitrieva¹ 

¹Russian Medical Academy of Continuous Professional Education, Moscow

²Z.A. Bashlyaeva Children City Clinical Hospital, Moscow 

The article is devoted to acute tonsillopharyngitis (ATP) and the most common cause of bacterial ATP — β-hemolytic group A streptococcus (BHGAS) — a pathogen transmitted by airborne droplets and affecting, exceptionally, humans. It affects up to 35% of pediatric patients, most commonly occurs in school-age children with a peak incidence of 7–8 years. The diagnosis complexity of ATP in BHGAS etiology is due to the symptoms similarity of the viral and streptococcal disease forms. It is noted that the irrational use of antibacterial therapy increases the risk of antibiotic resistance, the complications development in the patient, increases the burden on medical workers and the healthcare system. At the same time, the antibacterial treatment of acute streptococcal tonsillopharyngitis, conducted according to clinical recommendations, practically eliminates BHGAS in the pharynx and, thereby, significantly reduces the risk of complications. The importance concerning the active implementation of diagnostic tests, allowing in a short time (5–10 minutes), is substantiated to differentiate the viral and streptococcal cause of ATP. A simple and reliable way to confirm the streptococcal etiology of ATP is rapid test to detect group A streptococcus antigen in a smear from the posterior pharyngeal wall using test systems based, in particular, on the method of immunochromatography («Streptatest^®») — the gold standard for the diagnosis of streptococcal ATP, which does not require additional briefing for medical personnel. The results of the Streptatest allow timely and adequate prescribing of the necessary treatment to the patient.

Keywords: acute tonsillopharyngitis, β-hemolytic group A streptococcus, diagnosis, rapid test, immunochromatography.

For citation: Zakharova I.N., Berezhnaya I.V., Maykova I.D. et al. Acute tonsillopharyngitis of streptococcal etiology in children: the importance of rapid diagnosis. RMJ. 2023;2:67–71.