Abordaje actual del manejo diagnóstico y terapéutico de faringoamigdalitis por streptococcus pyogenes en atención primaria

Abstract

Pharyngotonsillitis is a common upper respiratory tract infection that affects the oropharynx, caused mainly by viruses. Streptococcus pyogenes is the main bacterial etiological agent. Odynophagia, cervical lymphadenopathy and fever greater than 38°C may occur. It has a high incidence of cases worldwide and represents a high rate of antibiotic prescriptions. Its diagnosis is based on the use of Centor and McIsaac diagnostic scales, and complementary tests such as the rapid antigen test and throat culture. The treatment of choice is penicillin V for 10 days, with the option of amoxicillin in children. Proper diagnosis and treatment help avoid antibiotic resistance and serious non-suppurative complications caused by S. pyogenes. OBJECTIVE: To describe the current diagnostic and therapeutic approach to Streptococcus pyogenes pharyngotonsillitis through clinical scoring scales and rapid tests using scientific evidence. METHODS: Descriptive study with a logical deductive method, through the review of bibliographic sources, through an analysis and synthesis of various updated scientific articles compiled from high-impact digital repositories such as PUBMED, ELSEIVER. CONCLUSIONS: In the current management of the diagnosis of streptococcal pharyngotonsillitis, the Centor and McIsaac scales are very useful; they help to screen patients who are candidates for complementary tests, such as the rapid antigen detection test and culture. Penicillin continues to be the treatment of choice, because resistance by S. pyogenes has not been recorded.