PEDIATRICS Vol. 48 No. 4 October 1971, pp. 573-582
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GUIDELINES FOR THE SELECTIVE USE OF THROAT CULTURES IN THE DIAGNOSIS OF STREPTOCOCCAL RESPIRATORY INFECTION

Larry H. Honikman M.D.1 and Benedict F. Massell M.D.1

1 The House of the Good Samaritan, Children's Hospital Medical Center, and the Department of Pediatrics, Harvard Medical School, Boston

A total of 6,093 respiratory and febrile illnesses experienced by children were analyzed with regard to symptoms. Our objective was to devise simple guidelines that would allow for the detection of most clinical group A streptococcal infections while eliminating the need for taking throat cultures in the majority of nonstreptococcal illnesses.

The results of the analysis led to the recommendation that throat cultures be taken in all illnesses with pure or predominant sore throat and fever of any degree and also in all other illnesses with an oral temperature of 101°F or higher even in the absence of sore throat.

Application of these guidelines would have involved taking throat cultures in 29.5% of the 6,093 illnesses observed and would have detected 88.1% of 469 clinical group A streptococcal infections estimated to be capable of causing an antistreptolysin O response and therefore potentially capable of causing rheumatic fever. The need for taking cultures in 70.5% of the 6,093 illnesses would have been obviated.

An additional 376 subclinical group A streptococcal infections capable of producing an antistreptolysin O response were observed in this study. Because of absence of symptoms these infections ordinarily would not have been detected.

Submitted on December 9, 1970
Accepted on March 20, 1971




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