BACKGROUND Some clinicians have questioned the accuracy of rapid diagnosis of group A streptococcal pharyngitis by commercial immunochemical antigen test kits in the setting of recent streptococcal pharyngitis, believing that the false-positive rate was increased because of presumed antigen persistence. METHODS We studied 443 patients--211 cases--who had clinical pharyngitis diagnosed as grou...

Acute pharyngitis is one of the most common illnesses for which children in the United States visit primary care providers; pediatricians make the diagnosis of acute pharyngitis, acute tonsillitis, or “strep throat” more than 7 million times annually. A partial list of the more common microorganisms that can cause acute pharyngitis is presented in Table 27-1. Most cases in children and adolesce...

In young adults with acute pharyngitis, the main differential diagnosis is between GAS pharyngitis, EBV infectious mononucleosis, or other causes of viral pharyngitis. A positive RST does not differentiate GAS colonization from infection as is well illustrated by this case. Laboratory test results must be interpreted in the appropriate clinical context to be diagnostically meaningful. The RST o...

Fine and colleagues’ article in this issue (1) adds an interesting variation on the “sore throat question.” Whether to treat or test patients with sore throat continues to generate differing opinions. International guidelines suggest 3 strategies: neither test nor treat anyone, test patients with a substantial probability of group A streptococcal (GAS) pharyngitis and treat those who test posit...

OBJECTIVE To prospectively evaluate the association between antibiotics used to treat acne and pharyngitis. DESIGN Cross-sectional and 9-month prospective cohort. SETTING Urban university setting. PARTICIPANTS University students. INTERVENTION Participants were asked to fill out a survey form, were swabbed for culture, and had a visual examination for acne. MAIN OUTCOME MEASURE Report...

OBJECTIVE Antibiotic treatment of Group A Streptococcus (GAS) pharyngitis is important in acute rheumatic fever (ARF) prevention, however clinical guidelines for prescription vary. GAS carriers with acute viral infections may receive antibiotics unnecessarily. This review assessed the prevalence of GAS pharyngitis and carriage in different settings. METHODS A random-effects meta-analysis was ...

Sore throat is one of the most common reasons for visits to family physicians. While most patients with sore throat have an infectious cause (pharyngitis), fewer than 20 percent have a clear indication for antibiotic therapy (i.e., group A beta-hemolytic streptococcal infection). Useful, well-validated clinical decision rules are available to help family physicians care for patients who present...

BACKGROUND Limited evidence exists as to the benefit of tonsillectomy in adult patients. We sought to determine the short-term efficacy of tonsillectomy for recurrent pharyngitis in adults. METHODS We conducted a randomized, controlled, parallel-group trial at a tertiary care ear, throat and nose centre in Oulu, Finland, between October 2007 and December 2010. Adult patients with recurrent ph...