Hopp til innhold
NHI.no
Annonse

Streptokokkhalsinfeksjon: Årsaker

Halsbetennelse starter ofte med en forkjølelse, det vil si en virusinfeksjon. En slik virusinfeksjon kan svekke immunforsvaret noe og derved bidra til at streptokokkbakterier - gruppe A betahemolytiske streptokokker (GAS), som normalt kan finnes i halsen, trenger inn i slimhinnene og medfører en kraftigere betennelse. I en frisk befolkning kan denne bakterien påvises hos 1-20 prosent av de undersøkte. Under streptokokk-epidemier kan en finne GAS hos 30-40 prosent av pasientene med halssmerter.

Annonse

Ulike former for fysisk og psykisk stress kan også medføre at immunforsvaret svekkes og gjøre deg mer sårbar for å utvikle halsbetennelse.

Under epidemier kan streptokokker spre seg fra person til person ved dråpesmitte. Dette medfører risiko for smitte dersom personer i nærmiljøet ditt er syke. Likevel er denne infeksjonen langt mindre smittsom enn de vanligste virusinfeksjonene, som influensa, forkjølelse og covid-19. 

Dette dokumentet er basert på det profesjonelle dokumentet Streptokokkhalsinfeksjon . Referanselisten for dette dokumentet vises nedenfor

  1. Kalra MG, Higgins KE, Perez ED. Common questions about streptococcal pharyngitis. Am Fam Physician. 2016 Jul 1;94(1):24-31.
  2. Folkehelseinstituttet. Smittevernveilederen. Streptokokk gruppe A-infeksjon - veileder for helsepersonell. Sist oppdatert 18.06.2019. Siden besøkt 16.10.2019. www.fhi.no
  3. Shaikh N, Leonard E, Martin JM. Prevalence of streptococcal pharyngitis and streptococcal carriage in children: a meta-analysis. Pediatrics 2010; 126: e557-64. Pediatrics
  4. Tanz RR, Shulman ST. Chronic pharyngeal carriage of group A streptococci. Pediatr Infect Dis J. 2007;26(2):175–176.
  5. Folkehelseinstituttet. Invasive infeksjoner, årsrapport 2017.
  6. Høye S, Fossum GH. Streptokokkhalsinfeksjon og skarlagensfeber. Nasjonale faglige retningslinjer for antibiotikabruk i primærhelsetjenesten. Oslo: Helsedirektoratet, sist oppdatert 16.06.2020. www.antibiotikaiallmennpraksis.no
  7. Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012;55(10):e86–e102.
  8. Linder JA, Chan JC, Bates DW. Evaluation and treatment of pharyngitis in primary care practice: the difference between guidelines is largely academic. Arch Intern Med. 2006;166(13):1374–1379.
  9. Lindbaek M, Hoiby EA, Lermark G, Steinsholt IM, Hjortdahl P. Predictors for spread of clinical group A streptococcal tonsillitis within the household. Scand J Prim Health Care 2004; 22: 239-43. PubMed
  10. Little P, Hobbs FD, Moore M, et al.; PRISM Investigators. Clinical score and rapid antigen detection test to guide antibiotic use for sore throats: randomised controlled trial of PRISM (primary care streptococcal management). BMJ. 2013;347:f5806.
  11. National Institute for Health and Care Excellence (NICE). Sore Throat (acute): antimicrobial prescribing. NICEguidance [NG84]. Published date: January 2018. Siden besøkt 7.11.2019 www.nice.org.uk
  12. Little P, Hobbs FD, Moore M. et al. Clinical score and rapid antigen detection test to guide antibiotic use for sore throats: randomised controlled trial of PRISM (primary care streptococcal management). BMJ 2013; 347: f5806. doi:10.1136/bmj.f5806 DOI
  13. Pediatriveiledere. Fra Norsk barnelegeforening. Akuttveileder: Akutt tonsillitt og skarlagensfeber. Revidert 2013. www.helsebiblioteket.no
  14. Shaikh N, Swaminathan N, Hooper EG. Accuracy and precision of the signs and symptoms of streptococcal pharyngitis in children: a systematic review. J Pediatr 2012; 160: 487-93. PubMed
  15. Legeforeningen. Gjør kloke valg. Norsk forening for allmennmedisin. Oppdatert 28.02.2020. Siden besøkt 11.02.2021 www.legeforeningen.no
  16. Worrall G, Hutchinson J, Sherman G, Griffiths J. Diagnosing streptococcal sore throat in adults: randomized controlled trial of in-office aids. Can Fam Physician 2007; 53: 666-71. PubMed
  17. Zwart S, Rovers MM, de Melker RA, et al. Penicillin for acute sore throat in children: randomised, double blind trial. BMJ 2003; 327: 1324-7. British Medical Journal
  18. Spinks A, Glasziou PP, Del Mar CB. Antibiotics for sore throat. Cochrane Database of Systematic Reviews 2013, Issue 11. Art. No.: CD000023. DOI: 10.1002/14651858.CD000023.pub4 DOI
  19. van Driel ML, De Sutter AIM, Habraken H, Thorning S, Christiaens T. Different antibiotic treatments for group A streptococcal pharyngitis. Cochrane Database of Systematic Reviews 2016, Issue 9. Art. No.: CD004406. DOI: 10.1002/14651858.CD004406.pub4. DOI
  20. Skoog Stahlgren G, Tyrstrup M, Edlund C, et al. Penicillin V four times daily for five days versus three times daily for 10 days in patients with pharyngotonsillitis caused by group A streptococci: randomised controlled, open label, non-inferiority study. BMJ. 2019 Oct 4;367:l5337. PubMed
  21. Hayward G, Thompson MJ, Perera R, Glasziou PP, Del Mar CB, Heneghan CJ. Corticosteroids as standalone or add-on treatment for sore throat. Cochrane Database of Systematic Reviews 2012, Issue 10. Art. No.: CD008268. DOI: 10.1002/14651858.CD008268.pub2 DOI
  22. Korb K, Scherer M, Chenot JF. Steroids as adjuvant therapy for acute pharyngitis in ambulatory patients: a systematic review. Ann Fam Med 2010; 8: 58-63. PubMed
  23. Schwartz RH, et al. A re-appraisal of the minimum duration of antibiotic treatment before approval of return to school for children with streptococcal pharyngitis. Pediatr Infect Dis J 2015. doi: 10.1097/INF.0000000000000883 DOI
  24. Burton MJ, Glasziou PP, Chong LY, Venekamp RP. Tonsillectomy or adenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD001802. DOI: 10.1002/14651858.CD001802.pub3. DOI
  25. van Staaij BK, van den Akker EH, Rovers MM, Hordijk GJ, Hoes AW, Schilder AGM . Effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or adenotonsillar hypertrophy: open, randomised controlled trial. BMJ 2004; 329: 651-4. British Medical Journal
  26. Paradise JL, Bluestone CD, Colborn DK, et al. Tonsillectomy and adenotonsillectomy for recurrent throat infection in moderately affected children. Pediatrics 2002; 110: 7-15. Pediatrics
  27. Baugh RF, Archer SM, Mitchell RB, et al.; American Academy of Otolaryngology–Head and Neck Surgery Foundation. Clinical practice guideline: tonsillectomy in children. Otolaryngol Head Neck Surg. 2011;144(1 suppl):S1–S30.
  28. Koskenkorva T, Koivunen P, Koskela M, et al. Short-term outcomes of tonsillectomy in adult patients with recurrent pharyngitis: a randomized controlled trial. CMAJ 2013 May 14;185(8):E331-6. doi: 10.1503/cmaj.121852. DOI
  29. Lüscher M, et al. Streptokokkhalsinfektion. Lægehåndbogen, sist oppdatert 19.02.2017.
  30. Vincent MT, Celestin N, Hussain AN. Pharyngitis. Am Fam Physician 2004; 69: 1465-70. PubMed
  31. Bejerot S, Bruno K, Gerland G, et al. Misstänk PANDAS hos barn med akuta neuropsykiatriska symptom. Läkartidningen 2013; 110: CDCD. PMID: 24187894 PubMed
Annonse
Annonse