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In Reply.—We agree with Dr Cimolai in three important respects: First, many of the non-group A streptococci that are detected only through the anaerobic culture technique may not be pathogenic. Careful speciation of non-group A organisms isolated using anaerobic vs conventional culture techniques would be a valuable first step in determining whether the increased anaerobic isolation of non-group A organisms is clinically relevant.
Second, the category "non-group A streptococci" is not homogeneous. Certain non-group A streptococci, especially those from the Lancefield group C, appear much more likely than others to cause pharyngitis. Even within the serogroup C, certain species have been recognized primarily as veterinary pathogens whereas other species have been associated more often with human illness. Further investigations should most logically focus on those species most closely associated with clinical pharyngitis.
Finally, the basic issue of how often non-group A streptococci cause pharyngitis remains unsettled. Our data suggest
HAYDEN GF, HENDLEY JO. β-Hemolytic Non-Group A Streptococci and Pharyngitis-Reply. Am J Dis Child. 1990;144(4):453. doi:10.1001/archpedi.1990.02150280074009