“Doughnut” Lesions

Comments · 74 Views

A 9-year-old girl presented to clinic with sore throat and fever. “Doughnut” lesions were seen on the palate, and throat culture confirmed infection with group A beta-hemolytic streptococcus.

The typical symptoms of streptococcal pharyngitis are sore throat, fever of greater than 38°C, tonsillar exudates, and enlarged tender cervical lymph nodes. ⠀

⏩Other symptoms include headache, nausea, vomiting, abdominal pain, muscle ache, scarlatiniform rash, and petechiae on the palate. ⠀

⏩The diagnosis of strep throat is unlikely with symptoms of red eyes, hoarseness, runny nose, or mouth ulcers. It is also less likely in the absence of fever. ⠀

⏩The most common bacterial organism causing acute pharyngitis in children is group A β-hemolytic streptococci.⠀

⏩Palatal hemorrhages may also accompany infectious mononucleosis, rubella (Forschheimer spots), roseola, viral hemorrhagic fevers, thrombocytopenia, and palatal trauma, but are more common with strep infection.⠀

⏩Throat culture is the criterion standard for diagnosis of Grp A strep infection (90% to 99% sensitive). ⠀

⏩Grp A streptococcal pharyngitis is usually a self-limited disease, and most signs and symptoms resolve spontaneously in 3 to 4 days. ⠀

⏩If administered early, antibiotics can shorten the duration of the illness by up to 1 day, but the main reason they are given is for prevention of acute rheumatic fever.