[Acute pharyngitis: value of the bacteriological diagnosis].
The aetiological diagnosis of acute pharyngitis relies upon laboratory examinations, but these are difficult to obtain in routine general practice. While taking throat swabs is mandatory in some clinical situations (membranous or ulcerous pharyngitis, special investigations in some patients) where it provides essential diagnostic data, it is in fact seldom performed in patients with common acute pharyngitis. Penicillin is systematically administered for fear of the severe sequelae of group A streptococci pharyngitis, but this type of infection occurs in only 10 to 20% of the cases so that on statistical grounds routine antibiotic therapy is not fully justified. For this reason, rapid diagnostic tests without cultures and feasible at the patient's bedside have been devised. These tests have excellent specificity, but their sensitivity is not so good. In addition, their use by general practitioners raises a problem of medical responsibility, and they are not reimbursed by the french Sécurité sociale. The future of these fast methods will depend on the solution of these two problems.
Fleurette
J
J
Laboratoire central de microbiologie, hôpital Edouard-Herriot, Lyon.
D000208:Acute Disease; D001431:Bacteriological Techniques; D006801:Humans; D008826:Microbial Sensitivity Tests; D010612:Pharyngitis / Q000175:diagnosis* / Q000382:microbiology*
Les angines aiguës: intérêt du diagnostic bactériologique.