Diagnosis and treatment of streptococcal pharyngitis

To the Editor.—

Dr Vincent Fulginiti,¹in his excellent editorial, implies that the "retching febrile child who clutches his throat in pain" probably has streptococcal pharyngitis. I believe this is somewhat misleading. It has been my experience that children with viral pharyngitis, infectious mononucleosis, and postnasal drip are more apt to have presenting complaints of severe sore throat. It is not unusual for the child with streptococcal pharyngitis or scarlet fever to present with some malaise and fever, and to mention a sore throat only on being questioned about it. For the past six months, we have been using the throat swab rapid-diagnosis method for confirming the diagnosis of streptococcal pharyngitis. We initially ran the tests along with our previous bacitracin-disk agar plate cultures and found virtual