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Streptococcal Pharyngitis

  • Mark Multach

Abstract

Two hundred years have passed since the recognition that rheumatic fever affects the heart.1 Since that time, our understanding, diagnosis, and treatment of the disease have changed dramatically. The recognition that pharyngitis was related to acute rheumatic fever (ARF) came in the early 1930s. In the early 1950s Wannamaker and co-workers showed that ARF could be prevented by early treatment of group A β-hemolytic streptococcal (GABHS) pharyngitis with penicillin.2,3 The association of a preceding GABHS pharyngitis, along with the discovery that early treatment of this infection could essentially eradicate the risk of rheumatic heart disease, has produced a remarkable change in the morbidity and mortality of this complication.

Keywords

Infective Endocarditis Sore Throat Rheumatic Fever Rheumatic Heart Disease Antigen Test 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Comroe, J. H., Jr., and Dripps, R. D. (eds.): The Top Ten Clinical Advances in Cardiovascular-Pulmonary Medicine and Surgery between 1945 and 1975. Vol. I. Data and Discussion. Final Report. United States Department of Health, Education, and Welfare, Washington, DC, 1977.Google Scholar
  2. 2.
    Denny, F. W., Wannamaker, L. W., Brink, W. R., et al.: Prevention of rheumatic fever: Treatment of the preceding streptococcic infection. JAMA 143: 151–153, 1950.CrossRefGoogle Scholar
  3. 3.
    Wannamaker, L. W., Rammelkamp, D. H., Jr., Denny, F. W., et al.: Prophylaxis of acute rheumatic fever by treatment of the preceding streptococcal infection with various amounts of depot penicillin. Am. J. Med. 10: 673–695, 1951.PubMedCrossRefGoogle Scholar
  4. 4.
    Cypress, B. K.: Office visits for diseases of the respiratory system. U.S. Department of Health, Education, and Welfare, Washington, DC, 1979.Google Scholar
  5. 5.
    Wannamaker, L. W.: Perplexity and precision in the diagnosis of streptococcal pharyngitis. Am. J. Dis. Child. 124: 352–358, 1972.PubMedGoogle Scholar
  6. 6.
    Komaroff, A. L., Pass, T. M., Aronson, M. D., et al.: The prediction of streptococcal pharyngitis in adults. J. Gen. Intern. Med. 1: 1–7, 1986.PubMedCrossRefGoogle Scholar
  7. 7.
    Brock, L. L., and Siegel, A. C.: Studies on the prevention of rheumatic fever: The effect of the time of initiation of treatment of streptococcal infections on the immune response of the host. J. Clin. Invest. 32: 630–632, 1953.PubMedCrossRefGoogle Scholar
  8. 8.
    Spagnuolo, M., and Tarata, A.: Rheumatic fever in siblings. Similarity of its clinical manifestations. N. Engl. J. Med. 278: 183–188, 1968.PubMedCrossRefGoogle Scholar
  9. 9.
    DiSciascio, G., and Taranta, A.: Rheumatic fever in children. Am. Heart J. 99: 635–658, 1980.PubMedCrossRefGoogle Scholar
  10. 10.
    Ayoub, E. M.: The search for host determinants of susceptibility to rheumatic fever: The missing link. Circulation 69: 197–201, 1984.PubMedCrossRefGoogle Scholar
  11. 11.
    Stollerman, G. H.: Nephritogenic and rheumatogenic group A streptococci. J. Infect. Dis. 120: 258–263, 1969.PubMedCrossRefGoogle Scholar
  12. 12.
    Land, M. A., and Bisno, A. L.: Acute rheumatic fever. A vanishing disease in suburbia. JAMA 249: 895–898, 1983.PubMedCrossRefGoogle Scholar
  13. 13.
    Coulehan, J. L., Baacke, G., Welty, T. K., and Goldtooth, N. L.: Cost-benefit of a streptococcal surveillance program among Navajo indians. Public Health Rep. 97: 73–77, 1982.PubMedGoogle Scholar
  14. 14.
    Catanzaro, F. J., Rammelkamp, C. H., Jr., and Chamovitz, R.: Prevention of rheumatic fever by treatment of streptococcal infections. II. Factors responsible for failures. N. Engl. J. Med. 259: 51–57, 1958.CrossRefGoogle Scholar
  15. 15.
    Nelson, J. D.: The effect of penicillin therapy on the symptoms and signs of streptococcal pharyngitis. Pediatr. Infect. Dis. 3: 10–13, 1984.PubMedCrossRefGoogle Scholar
  16. 16.
    Hutchison, B., and Yassi, A. L.: Resolving the sore throat dilemma. Can. Fam. Physician 27: 471–477, 1981.PubMedGoogle Scholar
  17. 17.
    Haight, T. H.: Erythromycin therapy of respiratory infections. I. Controlled studies on the comparative efficacy of erythromycin and penicillin in scarlet fever. J. Lab. Clin. Med. 10: 300–308, 1954.Google Scholar
  18. 18.
    Merenstein, J. H., and Rogers, K. D.: Streptococcal pharyngitis. Early treatment and management by nurse practitioners. JAMA 227: 1278–1282, 1974.PubMedCrossRefGoogle Scholar
  19. 19.
    Komaroff, A. L., Aronson, M. D., Pass, T. M., et al.: Serologic evidence of chlamydial and mycoplasmal pharyngitis in adults. Science 222: 927–929, 1983.PubMedCrossRefGoogle Scholar
  20. 20.
    Bennike, T., Bruchner-Mortenson, K., Kjaor, E., et al.: Penicillin therapy in acute tonsillitis, phlegmonous tonsillitis and ulcerative tonsillitis. Acta Med. Scand. 139: 253–274, 1951.PubMedCrossRefGoogle Scholar
  21. 21.
    Chamovitz, R., Rammelkanp, C. H., Wannamaker, L. W., et al.: The effect of tonsillectomy on the incidence of streptococcal respiratory disease and its complications. Pediatrics 26: 355–367, 1960.PubMedGoogle Scholar
  22. 22.
    Lowe, R.: Early Treatment of streptococcal pharyngitis. Ann. Emerg. Med. 13: 440–448, 1984.PubMedCrossRefGoogle Scholar
  23. 23.
    Breese, B. B., and Disney, F. A.: The accuracy of diagnosis of B streptococcal infections on clinical grounds. J. Pediatr. 44: 670–673, 1954.PubMedCrossRefGoogle Scholar
  24. 24.
    Eggenberger, K., Christen, J-P., Delarue, C., et al.: Streptococcal pharyngitis-tonsillitis in Swiss children. Diagnosis and management. Pediatrician 9: 295–308, 1980.Google Scholar
  25. 25.
    Siegel, A. C., Johnson, E. C., and Stollerman, G. H.: Controlled studies of streptococcal pharyngitis in a pediatric population. N. Engl. J. Med. 265: 559–566, 1961.CrossRefGoogle Scholar
  26. 26.
    Poses, R. M., Cebul, R. D., Collins, M., et al.: The accuracy of experienced physicians’ probability estimates for patients with sore throats. JAMA 254: 925–929, 1985.PubMedCrossRefGoogle Scholar
  27. 27.
    Wigton, R. S., Connor, J. L., and Centor, R. M.: Transportability of a decision rule for the diagnosis of streptococcal pharyngitis. Arch. Intern. Med. 146: 81–83, 1986.PubMedCrossRefGoogle Scholar
  28. 28.
    Wood, R. W., Tompkins, R. K., and Wolcott, B. W.: An efficient strategy for managing acute respiratory illness in adults. Ann. Intern. Med. 93: 757–763, 1980.PubMedGoogle Scholar
  29. 29.
    Greenfield, S., Bragg, F. E., McCraith, D. L., et al.: Upper respiratory tract complaint protocol for physician-extenders. Arch. Intern. Med. 133: 294–299, 1974.PubMedCrossRefGoogle Scholar
  30. 30.
    Walsh, B. T., Bookheim, W. W., Johnson, R. L., et al.: Recognition of streptococcal pharyngitis in adults. Arch. Intern. Med. 135: 1493–1497, 1975.PubMedCrossRefGoogle Scholar
  31. 31.
    Centor, R. M., Witherspoon, J. M., Dalton, H. P., et al.: The diagnosis of strep throat in adults in the emergency room. Med. Decis. Making 1: 239–246, 1981.PubMedCrossRefGoogle Scholar
  32. 32.
    Breese, B. B.: A simple scorecard for the tentative diagnosis of streptococcal pharyngitis. Am. J. Dis. Child. 131: 514–517, 1977.PubMedGoogle Scholar
  33. 33.
    Lowe, R.: Early treatment of streptococcal pharyngitis. Ann. Emerg. Med. 13: 440–448, 1984.PubMedCrossRefGoogle Scholar
  34. 34.
    Komaroff, A. L., Pass, T. M., Aronson, M. D., et al.: The prediction of streptococcal pharyngitis in adults. J. Gen. Intern. Med. 1: 1–7, 1986.PubMedCrossRefGoogle Scholar
  35. 35.
    Poses, R. M., Cebul, R. D., Collins, M., and Fager, S. S.: The importance of disease prevalence in transporting clinical prediction rules. Ann. Intern. Med. 105: 586–591, 1986.PubMedGoogle Scholar
  36. 36.
    Hoffman, S.: Lack of reliability of primary grouping of beta-hemolytic streptococci by culture of throat swabs with streptocult supplemented with bacitracin disks in general practice. J. Clin. Microbiol. 22: 497–500, 1985.Google Scholar
  37. 37.
    Larsson, P., and Lind, L.: The need for control of throat streptococcal cultures in general practice. Scand. J. Infect. Dis. 39(suppl.): 79–82, 1983.Google Scholar
  38. 38.
    Todd, J. K.: Throat cultures in the office laboratory. Pediatr. Infect. Dis. 1: 265–270, 1982.PubMedCrossRefGoogle Scholar
  39. 39.
    DuBois, D., Ray, V. G., Nelson, B., et al.: Rapid diagnosis of group A strep pharyngitis in the emergency department. Ann. Emerg. Med. 15: 157–159, 1986.PubMedCrossRefGoogle Scholar
  40. 40.
    Fischer, P. M., and Mentrup, P. L.: Comparison of throat culture and latex agglutination test for streptococcal pharyngitis. J. Fam. Pract. 22: 245–248, 1986.PubMedGoogle Scholar
  41. 41.
    Schwartz, R. H., Hayden, G. F., Mccoy, P., et al.: Rapid diagnosis pharyngitis in two pediatric offices using a latex agglutination kit. Pediatr. Infect. Dis. 4: 647–650, 1985.PubMedCrossRefGoogle Scholar
  42. 42.
    Roddey, O. F., Clegg, H. W., Clardy, L. T., et al.: Comparison of a latex agglutination test and four culture methods for identification of group A streptococci in a pediatric office laboratory. J. Pediatr. 108: 347–351, 1986.PubMedCrossRefGoogle Scholar
  43. 43.
    The Medical Letter: Rapid diagnostic tests for streptococcal pharyngitis. 27: 49–51, 1985.Google Scholar
  44. 44.
    Tompkins, R. K., Burnes, D. C., and Cable, W. E.: An analysis of the cost-effectiveness of pharyngitis management and acute rheumatic fever prevention. Ann. Intern. Med. 86: 481–492, 1977.PubMedGoogle Scholar
  45. 45.
    Lowy, F., and Steigbigel, N. H.: Infective endocarditis. Part III. Prevention of bacterial endocarditis. Am. Heart J. 96: 689–695, 1978.PubMedCrossRefGoogle Scholar
  46. 46.
    Shulman, S. T., Amren, D. P., Bisno, A. L., et al.: Prevention of bacterial endocarditis: A statement for health professionals by the Committee on Rheumatic Fever and Infective Endocarditis of the Council on Cardiovascular Disease in the Young. Circulation 70: 1123A–1127A, 1984.PubMedGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1988

Authors and Affiliations

  • Mark Multach
    • 1
  1. 1.Department of MedicineUniversity of Miami School of MedicineMiamiUSA

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