van Wyk M, van Rensburg A J, Schoeman H S
S Afr Med J. 1983 Apr 23;63(17):647-8.
The diagnosis of streptococcal sore throat on clinical grounds remains a problem. In this study the clinical prediction in a group of young adults corresponded with laboratory findings indicative of a streptococcal (group A or non-A) infection in 23% of cases. The culture of throat swabs was of little value, as the only group A culture-positive patient did not show an antibody response, indicating a carrier state. In 5 cases a streptococcal infection was diagnosed on rising antibody titres only, as culture remained negative. The value of rising antibody titres as a diagnostic tool is also questioned, since they occurred more frequently in the healthy controls than in the sore-throat group. Antibiotic treatment for sore throat was rarely supported by laboratory findings in the young adult population studied.
基于临床症状诊断链球菌性咽喉炎仍然是个问题。在本研究中，一组年轻人的临床诊断与实验室检查结果相符，表明23%的病例存在链球菌（A组或非A组）感染。咽喉拭子培养价值不大，因为唯一A组培养阳性的患者未显示抗体反应，提示为带菌状态。有5例仅根据抗体滴度升高诊断为链球菌感染，因为培养结果仍为阴性。抗体滴度升高作为诊断工具的价值也受到质疑，因为在健康对照组中比在咽喉疼痛组中更频繁出现。在所研究的年轻成人人群中，咽喉疼痛的抗生素治疗很少得到实验室检查结果的支持。
