Role of clinical findings in diagnosis of streptococcal pharyngitis

Beta-hemolytic streptococci are responsible for suppurative and non-suppurative complications and are potentially highly transmissible. It is a challenge to tell which patients with sore throat have streptococcal pharyngitis and which have viral illness. For evaluation of clinical prediction for streptococcal pharyngitis, 100 patients with sore throat whom penicillin were prescribed for them with impression of streptococcal pharyngitis were examined and throat cultures were taken. The frequency of beta-hemolytic streptococci group A was 6%, and it was 5% for streptococci groups C & G. Pneumococci was isolated from 5%. Pharyngeal erythema (100%), pharyngeal pain (97%), exudate (31%), fever (59%), cervical lymphadenopathy (31%) and strawberry tongue (4%) were detected. Of those with exudative pharyngitis, only three patients (9.6%) had streptococcal pharyngitis. Therefore, single clinical sign and symptom is not reliable for diagnosis of streptococcal pharyngitis and a number of standardized clinical decision rules and the rapid antigen detection tests (RATs) shoud be considered in streptococcal pharyngitis.