Group A beta-hemolytic streptococcal pharyngitis: current clinical concepts.

The classic triad of fever, pharyngeal exudate and tender anterior cervical adenopathy is present in only 15 percent of cases of group A beta-hemolytic streptococcal pharyngitis. Since clinical findings are unreliable, a rapid streptococcal test or a throat culture should be performed to confirm the diagnosis. A positive rapid test immediately identifies group A beta-hemolytic streptococcus and may help encourage patients to complete the course of antibiotics. However, a negative rapid test does not definitively rule out this organism and should be followed by a throat culture. Early antibiotic therapy reduces the duration of pharyngitis, minimizes transmission and lessens complications such as acute rheumatic fever and abscess. A 10-day course of oral penicillin or an intramuscular injection of penicillin G benzathine is recommended. Erythromycin is recommended for patients who are allergic to penicillin.