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April 1979

Diagnosing Streptococcal Pharyngitis

Author Affiliations

New York Medical College Flower and Fifth Avenue Hospitals Fifth Ave at 106th St New York, NY 10029

Am J Dis Child. 1979;133(4):449. doi:10.1001/archpedi.1979.02130040103032

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Dear Sir.—The article "A Simple Scorecard for the Tentative Diagnosis of Streptococcal Pharyngitis" by Breese that appeared in the Journal (131:514-517, 1977) pointed out that whenever a combination of factors, including clinical findings, are used a reasonably accurate prediction of streptococcal infection can be made.

I carried out a small study among 109 patients previously known to this office who were seen during the months of September through April with acute onset of sore throat accompanied by enlarged anterior cervical lymph nodes. All patients were older than 5 years of age. The prevalence of β-hemolytic streptococci was 50%. Among those with tender nodes (69 patients) 58% had positive cultures for β-hemolytic streptococci; and among those without tenderness (40 patients), 42% had positive cultures.

The correlation of sore throat and elevated temperature with a positive culture could not be evaluated accurately because many patients, although giving a history of

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