· The mechanism by which GAS causes pharyngitis is not well defined
· Asymptomatic pharyngeal carriers of the organism may have an alteration in host immunity (e.g., a breach in the pharyngeal mucosa) and the bacteria of the oropharynx, allowing colonization to become an infection
· Pathogenic factors associated with the organism itself may also play a role
· These include pyrogenic toxins, hemolysins, streptokinase, and proteinase
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