The diagnostic value of symptoms and signs in acute tonsillitis in children over the age of 10 and in adults.

267 outpatients with acute tonsillitis were studied with regard to clinical signs and symptoms and presence of beta-hemolytic streptococci. Beta-hemolytic streptococci were found in 169 patients (63%), compared to 6/64 healthy controls (9%). Of the tonsillitis patients with beta-hemolytic streptococci, 80% harboured group A and 20% groups C and G. Five out of 6 controls had group C and G streptococci. Eight clinical signs and symptoms of acute tonsillitis were rated on a 10-point scale. A correlation was found between redness in the oropharynx and on the tonsils and positive culture for beta-hemolytic streptococci group A. The total WBC count, polymorphonuclear leucocytes and ratio of polymorphonuclear to mononuclear leucocytes were strongly correlated to a positive culture for streptococci group A. Groups C and G did not show these correlations. The study stresses the importance of quantitative culture technique and the value of this for diagnosis in the acute ill patient with tonsillitis.