The Diagnosis of Streptococcal Pharyngitis

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Simple sore throat is one of the commonest maladies with which primary care physicians have to deal. Despite the multiplicity of potential etiologic agents (for example, Mycoplasma pneumoniae, Corynebacterium diphtheriae, Neisseria gonorrhoeae), the differential diagnosis almost always comes down to one seemingly simple question: Is this a viral pharyngitis or a “strep throat”? The former ordinarily merits symptomatic therapy only, while the latter should be treated with penicillin for at least 10 days to prevent the development of acute rheumatic fever.

Unfortunately, clinical acumen alone does not suffice to differentiate viral from group A streptococcal sore throat consistently enough to

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