You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


ABOUT ARCHIVES
Advanced Search

Welcome   | My Account | E-mail Alerts | Access Rights | Sign In


  Vol. 135 No. 11, November 1975 TABLE OF CONTENTS
  Archives
  •  Online Features
  ORIGINAL ARTICLES
 This Article
 •References
 •Full text PDF
 •Correction
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Contact me when this article is cited
 Related Content
 •Similar articles in this journal
 Social Bookmarking
  Add to CiteULike Add to Connotea Add to Del.icio.us Add to Digg Add to Reddit Add to Technorati Add to Twitter What's this?

Recognition of Streptococcal Pharyngitis in Adults

B. Timothy Walsh, MD; William W. Bookheim; Rita C. Johnson; Richard K. Tompkins, MD

Arch Intern Med. 1975;135(11):1493-1497.


Abstract

• In order to devise a strategy for the management of acute pharyngitis, the clinical features of 418 adults with sore throat were noted and throat cultures were obtained. Patients with cultures positive for group A β-hemolytic streptococci had a significantly higher (P≤.01) frequency of recent exposure to streptococcal infection, pharyngeal exudate, enlarged or tender cervical nodes, and high fever (greater double equals38.3 C [101 F]). Patients with negative cultures complained more frequently of cough. On the basis of these symptoms and signs, a clinical algorithm was developed and discriminant function scores were computed that identify patient populations with different probabilities of having streptococcal pharyngitis. The patients with moderate and high probabilities included 91% of patients with positive cultures but only 67% of the total patient population. These methods could be the basis for more efficient evaluation of adults with sore throat.

(Arch Intern Med 135:1493-1497, 1975)



Author Affiliations

From the Dartmouth-PROMIS Laboratory, Department of Medicine, Dartmouth Medical School, Hanover, NH, and the Matthew Thornton Health Plan, Inc., Nashua, NH. Dr. Walsh is now with the Albert Einstein College of Medicine, Bronx, NY. Dr. Tompkins is now with the U.S. Public Health Service Hospital, Seattle.


Footnotes

Received for publication Feb 7, 1975; accepted March 22.

Reprint requests to Box 3145, Seattle, WA 98114 (Dr. Tompkins).



Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter     What's this?


THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Diagnosing streptococcal sore throat in adults: Randomized controlled trial of in-office aids
Worrall et al.
cfp 2007;53:666-671.
ABSTRACT | FULL TEXT  

Patients Derogate Physicians Who Use a Computer-Assisted Diagnostic Aid
Arkes et al.
Med Decis Making 2007;27:189-202.
ABSTRACT  

Antibiotic Treatment of Children With Sore Throat
Linder et al.
JAMA 2005;294:2315-2322.
ABSTRACT | FULL TEXT  

Measuring the Quality of Care for Group A Streptococcal Pharyngitis in 5 US Health Plans
Mangione-Smith et al.
Arch Pediatr Adolesc Med 2005;159:491-497.
ABSTRACT | FULL TEXT  

Diagnosis and Management of Adults with Pharyngitis: A Cost-Effectiveness Analysis
Neuner et al.
ANN INTERN MED 2003;139:113-122.
ABSTRACT | FULL TEXT  

Diagnosing Strep Throat in the Adult Patient: Do Clinical Criteria Really Suffice?
Bisno
ANN INTERN MED 2003;139:150-151.
FULL TEXT  

Validation and Modification of Streptococcal Pharyngitis Clinical Prediction Rules
McGinn et al.
Mayo Clin Proc. 2003;78:289-293.
ABSTRACT  

Antibiotics for Common Respiratory Tract Infections in Adults
Hirschmann
Arch Intern Med 2002;162:256-264.
ABSTRACT | FULL TEXT  

Antibiotic Treatment of Adults With Sore Throat by Community Primary Care Physicians: A National Survey, 1989-1999
Linder and Stafford
JAMA 2001;286:1181-1186.
ABSTRACT | FULL TEXT  

Principles of Appropriate Antibiotic Use for Treatment of Nonspecific Upper Respiratory Tract Infections in Adults: Background
Gonzales et al.
ANN INTERN MED 2001;134:490-494.
ABSTRACT | FULL TEXT  

Principles of Appropriate Antibiotic Use for Acute Pharyngitis in Adults: Background
Cooper et al.
ANN INTERN MED 2001;134:509-517.
ABSTRACT | FULL TEXT  

Does This Patient Have Strep Throat?
Ebell et al.
JAMA 2000;284:2912-2918.
ABSTRACT | FULL TEXT  

Users' Guides to the Medical Literature: XXII: How to Use Articles About Clinical Decision Rules
McGinn et al.
JAMA 2000;284:79-84.
ABSTRACT | FULL TEXT  

Cost-effective Management of Sore Throat: It Depends on the Perspective
Pichichero
Arch Pediatr Adolesc Med 1999;153:672-674.
FULL TEXT  

Management of Sore Throats in Children: A Cost-effectiveness Analysis
Tsevat and Kotagal
Arch Pediatr Adolesc Med 1999;153:681-688.
ABSTRACT | FULL TEXT  

Using Treatment-tradeoff Preferences to Select Diagnostic Strategies: Linking the ROC Curve to Threshold Analysis
Deneef and Kent
Med Decis Making 1993;13:126-132.
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  

Cassandra and the Clinician: Are Clinical Prediction Rules Changing the Practice of Medicine?
Epstein
ANN INTERN MED 1990;113:646-647.
ABSTRACT  

Diagnosis of Group A {beta}-Hemolytic Streptococcus Using Clinical Scoring Criteria, Directigen 1-2-3 Group A Streptococcal Test, and Culture
Reed et al.
Arch Intern Med 1990;150:1727-1732.
ABSTRACT  

Cost-effectiveness and the Management of Pharyngitis-Reply
Cebul and Poses
JAMA 1987;257:2169-2169.
ABSTRACT  

The Comparative Cost-effectiveness of Statistical Decision Rules and Experienced Physicians in Pharyngitis Management
Cebul and Poses
JAMA 1986;256:3353-3357.
ABSTRACT  

The Management of Sore Throat: Adjusting to Success
Dans
JAMA 1986;256:3392-3393.
ABSTRACT  

Diagnostic Decision: Throat Cultures and Rapid Tests for Diagnosis of Group A Streptococcal Pharyngitis
CENTOR et al.
ANN INTERN MED 1986;105:892-899.
ABSTRACT  

The Importance of Disease Prevalence in Transporting Clinical Prediction Rules: The Case of Streptococcal Pharyngitis
POSES et al.
ANN INTERN MED 1986;105:586-591.
ABSTRACT  

Transportability of a Decision Rule for the Diagnosis of Streptococcal Pharyngitis
Wigton et al.
Arch Intern Med 1986;146:81-83.
ABSTRACT  

The Accuracy of Experienced Physicians' Probability Estimates for Patients With Sore Throats: Implications for Decision Making
Poses et al.
JAMA 1985;254:925-929.
ABSTRACT  

Applicability of a Scoring System in the Diagnosis of Streptococcal Pharyngitis
Funamura and Berkowitz
CLIN PEDIATR 1983;22:622-626.
ABSTRACT  

The Diagnosis of Strep Throat in Adults in the Emergency Room
Centor et al.
Med Decis Making 1981;1:239-246.
 

An Efficient Strategy for Managing Acute Respiratory Illness in Adults
WOOD et al.
ANN INTERN MED 1980;93:757-763.
ABSTRACT  

Streptococcal Pharyngitis: Diagnosis by Gram Stain
CRAWFORD et al.
ANN INTERN MED 1979;90:293-297.
ABSTRACT  

An Analysis of the Cost-Effectiveness of Pharyngitis Management and Acute Rheumatic Fever Prevention
TOMPKINS et al.
ANN INTERN MED 1977;86:481-492.
ABSTRACT  





HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 1975 American Medical Association. All Rights Reserved.