A 6-year-old boy presents with fever, sore throat, and swollen tender anterior cervical lymph nodes. Examination reveals tonsillar exudates and petechiae on the soft palate, with an absence of cough and coryza (Centor score 4). Rapid antigen detection test is positive for Group A Streptococcus. What is the primary purpose of penicillin therapy in this child?

Answer and explanation

Correct answer: A. To prevent acute rheumatic fever and suppurative complications

  1. Step 1: Antibiotic treatment of Group A streptococcal pharyngitis shortens illness duration and prevents suppurative sequelae.
  2. Step 2: Crucially, it is effective in preventing acute rheumatic fever and subsequent rheumatic heart disease.
Answer
To prevent acute rheumatic fever and suppurative complications.
Why not the others: 'To eliminate the risk of post-streptococcal glomerulonephritis' is incorrect because early antibiotic therapy has NOT been shown to prevent post-streptococcal glomerulonephritis; 'To permanently eradicate normal oral streptococcal colonization' is neither possible nor desirable; 'To prevent progression to viral infectious mononucleosis' is unrelated since EBV is a viral infection.

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