August 5, 1992, Vol 268, No. 5 >

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ARTICLE | August 5, 1992

Diagnosing Streptococcal Pharyngitis

Edward L. Kaplan, MD; Don P. Amren, MD

JAMA. 1992;268(5):599. doi:10.1001/jama.1992.03490050047008.

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To the Editor. —The article entitled "Insensitivity of Rapid Antigen Detection Methods and Single Blood Agar Plate Culture for Diagnosing Streptococcal Pharyngitis" by Wegner and colleagues,¹ while attempting to assist clinicians in management of group A streptococcal infections, unfortunately reaches unjustified conclusions without taking a number of important factors into consideration.First and most important, it is very difficult to believe that experienced microbiologists can find group A streptococci on only 58% of the plates after 24 hours and on only approximately 70% of the plates after 2 days. Even if there is an accepted discordance rate (one positive and one negative) of about 10% when using two swabs as shown in reference 8 of the article, this still indicates that those who read the single plates missed about 20%. This is unacceptably high for a laboratory.The authors could have attempted to explain this unexpected finding by performing

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Kaplan EL, Amren DP. Diagnosing Streptococcal Pharyngitis. JAMA. 1992;268(5):599. doi:10.1001/jama.1992.03490050047008.

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