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November 1975

Recognition of Streptococcal Pharyngitis in Adults

Author Affiliations

From the Dartmouth-PROMIS Laboratory, Department of Medicine, Dartmouth Medical School, Hanover, NH, and the Matthew Thornton Health Plan, Inc., Nashua, NH. Dr. Walsh is now with the Albert Einstein College of Medicine, Bronx, NY. Dr. Tompkins is now with the U.S. Public Health Service Hospital, Seattle.

Arch Intern Med. 1975;135(11):1493-1497. doi:10.1001/archinte.1975.00330110083011

• In order to devise a strategy for the management of acute pharyngitis, the clinical features of 418 adults with sore throat were noted and throat cultures were obtained. Patients with cultures positive for group A β-hemolytic streptococci had a significantly higher (P≤.01) frequency of recent exposure to streptococcal infection, pharyngeal exudate, enlarged or tender cervical nodes, and high fever (≧38.3 C [101 F]). Patients with negative cultures complained more frequently of cough. On the basis of these symptoms and signs, a clinical algorithm was developed and discriminant function scores were computed that identify patient populations with different probabilities of having streptococcal pharyngitis. The patients with moderate and high probabilities included 91% of patients with positive cultures but only 67% of the total patient population. These methods could be the basis for more efficient evaluation of adults with sore throat.

(Arch Intern Med 135:1493-1497, 1975)