Can group A beta haemolytic streptococcal sore throats be identified clinically?

OBJECTIVE

To differentiate the clinical manifestations of a Group A beta haemolytic streptococcal throat infection from viral and other bacterial infections.

SETTING

Outpatients' department, Lady Ridgeway Hospital, Colombo.

PATIENTS AND METHODS

Children aged 3 to 12 years attending with a sore throat. Throat swabs were taken and relevant details were obtained using a questionnaire. They were examined for significant cervical lymphadenopathy and tonsillar exudate.

RESULTS

Group A beta haemolytic streptococci were isolated from 61 (44.5%) throat swabs. Clinical differentiation of Group A beta haemolytic streptococcal sore throats was not possible as none of the symptoms or signs were significantly associated with the presence of this organism.

CONCLUSIONS

Group A beta haemolytic streptococcal sore throats cannot be identified clinically, so that throat swabs for culture are necessary in children with sore throat. In the absence of this facility, it is reasonable to treat sore throats in children as for beta haemolytic streptococci.