(1) The upper respiratory tract should be examined for evidence of otitis media, rhinorrhea, nasal polyposis, and pharyngitis .(2) Group A streptococci are the most important human pathogens causing acute pyogenic infections such as pharyngitis and pyoderma.(3) As in streptococcal pharyngitis , acute rheumatic fever and poststreptococcal glomerulonephritis most often occur in children.(4) The numbers for acute bronchitis, pharyngitis , and sinusitis increased sharply in 1995-in some cases from almost zero to several hundred per year.(5) The great majority of cases begin as a tonsillitis or pharyngitis with occasional cases associated with mastoiditis, otitis media, parotitis, sinusitis and dental infections.