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October 5, 1964

Sore Throat—A Diagnostic and Therapeutic Dilemma

JAMA. 1964;190(1):81. doi:10.1001/jama.1964.03070140087029

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To the Editor:—  I wish to comment on Dr. Stollerman's Clinical Management contribution, "Sore Throat-A Diagnostic and Therapeutic Dilemma" (JAMA189:145 [July 13] 1964). My concern is the mention of Hemophilus as an etiological agent of pharyngitis in infants and very small children. The author mentions the concern for obtaining cultures on appropriate media to obtain the Hemophilus organism. In infants as well as in older children and adults, the bacterial agents of pure pharyngitis are the group A βhemolytic streptococci and Corynebacterium diphtheriae. While it is known that type B Hemophilus influenzae causes acute epiglottitis, type A Hemophilus influenzae is considered to be part of the normal flora in infants and small children, especially those under the age of 2 years. The former type causes a fulminant systemic condition in addition to epiglottitis, and is not considered to be a pharyngitis. I submit this for consideration so that

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