Examination of pharyngeal secretions to determine the etiology of pharyngitis.

Wright-stained throat smears from 174 outpatients with a chief complaint of sore throat were examined. In the presence of tonsillar and/or pharyngeal exudate, cervical lymphadenitis, temperature greater than or equal to 24 less than or equal to 72h, examination of the throat smears would have doubled the accuracy of differentiating streptococcal pharyngitis (SP) from nonstreptococcal pharyngitis (NSP). In the presence of one, two, three, or all four of the preceding presenting characteristics, examination of throat smears would have increased the diagnostic accuracy by 46, 50, 13, and 14 per cent, respectively. Examination of a Wright-stained throat smear may help distinguish SP from NSP among patients in an outpatient setting where follow-up and, therefore, treatment based on culture results may not be optimal.