 |
|
Clinical and Microbiological Evidence for Endemic Pharyngitis Among Adults Due to Group C Streptococci
Frederick A. Meier, MD;
Robert M. Centor, MD;
Leroy Graham, Jr, PhD;
Harry P. Dalton, PhD
Arch Intern Med. 1990;150(4):825-829.
Abstract
| |
• Group C β-hemolytic streptococci cause rare epidemic outbreaks of pharyngitis, but their role in sporadic endemic pharyngitis has been uncertain. We addressed the question of whether non–group A β-hemolytic streptococci are associated with endemic pharyngitis in two ways. First, we compared rates of isolation from throat swabs of group A, B, C, and G and ungrouped β-hemolytic streptococci ("culture negative") in adult patients vs those rates in controls. Second, we collected in standardized form clinical indexes of patients with pharyngitis: signs and symptoms graded for severity, the examining physician's subjective estimate of the probability of streptococcal pharyngitis, a logistic regression score predicting streptococcal pharyngitis, and whether antibiotic therapy was prescribed. After collecting data and cultures on 1425 patients with sore throats and cultures on 284 controls, we found the following: group C streptococci were isolated significantly more frequently in patients with sore throats than in controls (6% vs 1.4%); four clinical signs and two symptoms distinguished group C–associated pharyngitis as more severe than culture-negative pharyngitis; and six clinical signs and one symptom distinguished group C–associated pharyngitis as less severe than group A pharyngitis. Physicians' subjective estimates, logistic regression scores, and antibiotic treatment all characterized group C–associated pharyngitis as more severe than culture-negative sore throats but less severe than group A pharyngitis. From these data we present the first definitive evidence that group C streptococci are associated with endemic pharyngitis, show that clinical presentation distinguishes a group of patients with group C–associated pharyngitis from populations with culture-negative sore throats and from those with group A pharyngitis. Physicians' response to that presentation merits consideration in the context of rapid group-specific diagnosis of streptococcal pharyngitis by group A antigen tests.
(Arch Intern Med. 1990;150:825-829)
Author Affiliations
From the Departments of Pathology (Drs Meier, Graham, and Dalton) and Internal Medicine (Drs Meier and Centor), Medical College of Virginia, Virginia Commonwealth University, Richmond. Dr Centor was a Teaching and Research Scholar of the American College of Physicians during this project.
Footnotes
Accepted for publication December 5, 1989.
Reprint requests to Box 662, MCV Station, Richmond, VA 23298 (Dr Meier).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Prevention of Rheumatic Fever and Diagnosis and Treatment of Acute Streptococcal Pharyngitis: A Scientific Statement From the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: Endorsed by the American Academy of Pediatrics
Gerber et al.
Circulation 2009;119:1541-1551.
ABSTRACT
| FULL TEXT
Pharyngitis management: focusing on where we agree.
Centor and Cohen
Arch Intern Med 2006;166:1345-1346.
FULL TEXT
Rapid Diagnosis of Pharyngitis Caused by Group A Streptococci
Gerber and Shulman
Clin. Microbiol. Rev. 2004;17:571-580.
ABSTRACT
| FULL TEXT
Antibiotic Susceptibilities of Group C and Group G Streptococci Isolated from Patients with Invasive Infections: Evidence of Vancomycin Tolerance among Group G Serotypes
Zaoutis et al.
J. Clin. Microbiol. 1999;37:3380-3383.
ABSTRACT
| FULL TEXT
Non-group A streptococci: are they pathogens in the throat?
Chowdhury et al.
The Journal of the Royal Society for the Promotion of Health 1997;117:160-163.
ABSTRACT
Streptococcal Group C Bacteremia: Survey in Israel and Analytic Review
Carmeli et al.
Arch Intern Med 1995;155:1170-1176.
ABSTRACT
Practice Variation in the Management of Pharyngitis: The Importance of Variability in Patients' Clinical Characteristics and in Physicians' Responses to Them
Poses et al.
Med Decis Making 1993;13:293-301.
ABSTRACT
Clinical Scoring System in the Evaluation of Adult Pharyngitis
Seppala et al.
Arch Otolaryngol Head Neck Surg 1993;119:288-291.
ABSTRACT
The Impact of a Rapid Screen for Streptococcal Pharyngitis on Clinical Decision Making in the Emergency Department
Hedges et al.
Med Decis Making 1991;11:119-124.
ABSTRACT
Association of Group C {beta}-Hemolytic Streptococci With Endemic Pharyngitis Among College Students
Turner et al.
JAMA 1990;264:2644-2647.
ABSTRACT
|
