title: Group A beta-hemolytic streptococcal pharyngitis: current clinical concepts.
abstract: The classic triad of fever, pharyngeal exudate and tender anterior cervical adenopathy is present in only 15 percent of cases of group A beta-hemolytic streptococcal pharyngitis. Since clinical findings are unreliable, a rapid streptococcal test or a throat culture should be performed to confirm the diagnosis. A positive rapid test immediately identifies group A beta-hemolytic streptococcus and may help encourage patients to complete the course of antibiotics. However, a negative rapid test does not definitively rule out this organism and should be followed by a throat culture. Early antibiotic therapy reduces the duration of pharyngitis, minimizes transmission and lessens complications such as acute rheumatic fever and abscess. A 10-day course of oral penicillin or an intramuscular injection of penicillin G benzathine is recommended. Erythromycin is recommended for patients who are allergic to penicillin.
authors.affiliation: Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville.
authors.forename: D
authors.initials: D
authors.lastname: Kiselica
mesh_terms: D000284:Administration, Oral; D000465:Algorithms; D002353:Carrier State / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D003937:Diagnosis, Differential; D004917:Erythromycin / Q000627:therapeutic use; D006801:Humans; D007273:Injections, Intramuscular; D010406:Penicillins / Q000627:therapeutic use; D010612:Pharyngitis / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D013297:Streptococcus pyogenes
chemical_list: D010406:Penicillins; D004917:Erythromycin