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June 1978

Streptococcal Pharyngitis and Scarlet Fever

Author Affiliations

From the Department of Pediatrics, University of Rochester Medical Center, Rochester, NY. Dr Breese is now professor emeritus.

Am J Dis Child. 1978;132(6):612-616. doi:10.1001/archpedi.1978.02120310076017

The most common streptococcal entity seen in temperate climates is variously called tonsillitis, pharyngitis, or streptococcal sore throat. All three are etiologically synonymous, and most practitioners refer to these as "strep throat." About two thirds of the patients with streptococcal infection seen in my practice fit into this diagnostic category. Various aspects of this entity have been described by astute clinicians in the past 35 years.1-10

CLINICAL PICTURE OF PHARYNGITIS  Typically the patient with a strep throat is a child from 5 to 8 years of age. The onset of the disease is usually sudden, the parent frequently being able to date it almost to the hour. Headache, sore throat, fever, nausea, and vomiting, often with abdominal pain, are initial symptoms. The child spontaneously goes to bed and refuses meals. The mother may note that his throat is red and that there is a peculiar, almost characteristic odor to

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