Cardiovascular and Respiratory Conditions Essay
Cardiovascular and Respiratory Conditions Essay
Cardiovascular and Respiratory Conditions Essay
Group A Strep Pharyngitis
Group A Strep Pharyngitis
Group A strep pharyngitis is an acute pharyngitis with sudden onset of sore throat, odynophagia, fever, headache, abdominal pain, nausea, and vomiting. The condition is common among children and accounts for about 20-30% of sore throats in children and 5-15% in adults (CDC, n.d.). Diagnosing the condition is challenging and requires a clinical diagnosis supported by a lab diagnosis. Its management depends on the cause, and antibiotics are on the frontline of GABHS Pharyngitis management.
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Diagnostic Testing
Group A Beta Hemolytic Streptococci pharyngitis presents with fever, tonsillar exudates, and cervical adenopathy symptoms. History and physical examination are vital to diagnosis but cannot provide a definitive diagnosis. Miller et al. (2020) note that the goal standard for diagnosing GABHS pharyngitis is throat culture and rapid antigen detection. However, physical examination and health history can help determine the patients that need lab testing. The significant symptoms include the absence of a cough, swollen/tender anterior cervical nodes, fever (above 1040F), and tonsillar exudates or swelling (Luo et al., 2019). These can then trigger laboratory investigations.
Differential Dx and ICD codes
The disease’s ICD 10 code is J02.0. The differential diagnoses include gastroesophageal reflux disease (K21.0), thyroiditis (E06.9), nasal foreign body (T17.0XXA), and viral pharyngitis (J02.8). Gastroesophageal reflux disease presents with painful regurgitation of food matter after eating that disappears after 2-3 hours. Elevated thyroid hormone levels and enlarged thyroid help eliminate the diagnosis. Nasal foreign bodies present with severe rhinitis and congestion, and coughing is common due to nasal drip into the trachea. Viral pharyngitis presents with cough, a significant gold standard for differentiation between GABHS and viral pharyngitis.
Treatment Plans:
Treatment for this condition entails pharmacological and supportive care, patient education, and follow-up as follows:
1. Pharmacologic Care: The medications to help manage the condition are penicillin per oral, 250mg twice daily TID, 250mg 4mg daily or 500mg twice daily or amoxicillin per oral 50mg/kg OD, maximum 1000mg or 25mg/kg twice daily (Mustafa & Ghaffari, 2020). Another medication is benzathine penicillin G intramuscular based on weight (1200U for those above 27kg and 600000 for patients below 27kg) (Mustafa & Ghaffari, 2020). Erythromycin and first-generation cephalosporins are treatment options, especially for penicillin allergy patients. First-generation cephalosporins have better efficacy against GABHS pharyngitis than other medications in the alternative group.
2. Supportive Care: Supportive care, especially in children, is significant. The strategies include getting plenty of rest, avoiding talking, drinking adequate fluids to moisten the throat, and avoiding caffeine and alcohol (Wolford et al., 2022).
3. Patient Education: Patient education for this patient covers areas such as the condition, management, and prevention of chronic illness. Taking medications is necessary as prescribed by the physician. Education on supportive care interventions is also necessary. General hygiene practices such as cough and sneeze etiquette are also significant, and patients should avoid going to public places until they are healed (Wolford et al., 2022). Other interventions include trying comforting foods while avoiding coffee and alcohol. Avoiding cigarette smoke and other irritants is also important.
4. Follow-Up: A clinic appointment for review after one week and then after two weeks is necessary. There is a lack of specific clinical guidelines for the condition hence the reliance on organizational policies. The medications are given last for about ten days, and it is vital to reevaluate the patient to determine how she reacts to the medications and any need for change. However, patients should be reevaluated if symptoms do not disappear within 72 hours (Wolford et al., 2023).
Conclusion
Pharyngitis is an acute upper respiratory tract illness that affects majorly children. Viral pharyngitis is the most common, and it is essential to differentiate viral from strep A pharyngitis. Its management entails pharmacologic interventions (penicillin antibiotics are the first-line treatment interventions) and supportive care. Supportive care focuses on the rehydration of the throat and avoiding irritants. Patient education and follow-up are patient-specific, focusing on ensuring quality patient outcomes.
 
References
Center for Disease Control and Prevention (CDC), (n.d.). Group A Streptococcal (GAS) Disease: Strep Throat. Accessed 24th March 2023, from https://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html
Luo, R., Sickler, J., Vahidnia, F., Lee, Y. C., Frogner, B., & Thompson, M. (2019). Diagnosis and management of group A streptococcal pharyngitis in the United States, 2011–2015. BMC Infectious Diseases, 19, 1–9. https://doi.org/10.1186/s12879-019-3835-4
Miller, K. M., Carapetis, J. R., Van Beneden, C. A., Cadarette, D., Daw, J. N., Moore, H. C., Bloom, D. E., & Cannon, J. W. (2022). The global burden of sore throat and group A Streptococcus pharyngitis: A systematic review and meta-analysis. EClinicalMedicine, 48, 101458. https://doi.org/10.1016/j.eclinm.2022.101458
Mustafa, Z., & Ghaffari, M. (2020). Diagnostic methods, clinical guidelines, and antibiotic treatment for group A streptococcal pharyngitis: a narrative review. Frontiers in Cellular and Infection Microbiology, 10, 563627. https://doi.org/10.3389/fcimb.2020.563627
Wolford, R. W., Goyal, A., Syed, S. Y. B., & Schaefer, T. J. (2022). Pharyngitis. In StatPearls [Internet]. StatPearls Publishing.
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Provide or suggest info on Pharyngitis, group A strep.
Diagnostic Testing:
Differential Dx and ICD codes:
Treatment Plans:
1) Pharmacologic Care
2) Supportive Care
3) Patient Education
4) Follow-Up:
