Pharyngitis, or sore throat, is the most common manifestation of infection with Streptococcus pyogenes. Sore throat is a frequently presenting complaint for outpatient medical visits; as a result, infection with S. pyogenes is diagnosed in 20 to 40% of pharyngitis cases in children, and in 5 to 15% in adults. Scarlet fever denotes a clinical syndrome that is characterized by the presence of a rash along with an S. pyogenes infection, usually pharyngitis. In this chapter, the topics covered include pathogenesis of pharyngitis, animal models of S. pyogenes pharyngitis, adherence of S. pyogenes to epithelial cells, intracellular survival and persistence in the pharynx, regulation of capsule production, S. pyogenes survival in the pharynx, and immunity to pharyngitis. Finally, there is an overview and discussion of clinical features, complications, diagnosis, and treatment of these diseases.
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