Streptococcal Pharyngitis

Question 1

Life threatening high risk findings

Answer 1

.1-Airway Obstruction:
Peritonsillar abscess or retropharyngeal abscess
Signs: muffled voice (“hot potato” voice), trismus, neck swelling, drooling, difficulty swallowing, stridor, or respiratory distress.
Risk: can compromise the airway if not promptly managed.
2. Systemic Toxicity (Invasive Streptococcal Infection):
Streptococcal toxic shock syndrome (STSS)
Signs: hypotension, multiorgan failure, rapidly progressive rash, altered mental status.

Rare but life-threatening, especially if bacteria invade the bloodstream or deep tissues.

3. Necrotizing Fasciitis (esp. head/neck region):

Rapidly spreading soft tissue infection, often with disproportionate pain, swelling, and systemic signs of sepsis.

A surgical emergency.
4. Sepsis or Bacteremia:

Especially in immunocompromised patients or those with delayed diagnosis/treatment.

Question 2

Red Flag Signs Warranting Emergency Evaluation:

Answer 2

1-Stridor or respiratory distress

2-Drooling or inability to swallow

3-Severe unilateral throat pain with trismus تشنج أو تيبس في عضلات الرقبة

4-High fever with neck stiffness/swelling

5-Altered mental status or hypotension