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In Reply.—Dr Lopez' letter is of interest to those of us trying to increase the accuracy of a tentative diagnosis of streptococcal infection based on clinical criteria prior to the report of the culture.
Using the information given on his patients and assuming fever to be present in those with swollen tender glands, each patient would score 31 points on the 9-point system as follows:
Sore throat 4
Season (September to April) 3 (mean)
Age, 5 to 10 years 4
Abnormal glands 4
Temperature, > 38 °C 4
Cough (unknown) 4
Headache (unknown) 2
Abnormal pharynx (unknown) 3
WBC count not done 3
Fifty-eight percent of such patients in his series were found to have positive cultures. This is almost identical to the 56.5% positive cultures found in our patients with the same score. Although such a score favors a streptococcal diagnosis it is in the
BREESE BB. Diagnosing Streptococcal Pharyngitis-Reply. Am J Dis Child. 1979;133(4):449. doi:10.1001/archpedi.1979.02130040103033
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