Kiselica D
Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville.
Am Fam Physician. 1994 Apr;49(5):1147-54.
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.
仅15%的A组β溶血性链球菌性咽炎病例会出现发热、咽部渗出物和颈前淋巴结触痛这一典型三联征。由于临床表现不可靠，应进行快速链球菌检测或咽拭子培养以确诊。快速检测呈阳性可立即确定A组β溶血性链球菌感染，这可能有助于鼓励患者完成抗生素疗程。然而，快速检测呈阴性并不能完全排除该病原体，应接着进行咽拭子培养。早期抗生素治疗可缩短咽炎病程，减少传播，并降低诸如急性风湿热和脓肿等并发症的发生。推荐口服青霉素10天疗程或肌内注射苄星青霉素G。对青霉素过敏的患者推荐使用红霉素。
