Norman D. Corwin, MD
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Corwin N.; Diagnosis and Management of Adults with Pharyngitis. Ann Intern Med. 2004;140:762. doi: 10.7326/0003-4819-140-9-200405040-00021
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Published: Ann Intern Med. 2004;140(9):762.
TO THE EDITOR:
I take exception with the conclusions of Neuner and colleagues in their article on the diagnosis and management of adults with pharyngitis (1). I am not an academic, but the late Dr. Louis Weinstein was. He related the following tale on more than one occasion while I was a student at Haynes Memorial Hospital in Boston, Massachusetts, some years ago. Dr. Weinstein became concerned about the validity of throat cultures when he was able to obtain only a 70% positive return on known group A β-hemolytic streptococcal infections, using as his gold standard a personally documented increase in the antistreptolysin-O (ASLO) titer (blood was drawn twice, once on seeing the individual for the first time and the second time 2 weeks later). Dr. Weinstein made his own blood agar plates, personally performed the throat culture, and did the serologic work himself. He repeated the study and got identical results. He then spoke with another pioneer in the field, Dr. Charles H. Rammelkamp Jr. in Cincinnati, Ohio, who stated that he, too, obtained the identical result, namely only a 70% positive throat culture return when compared with the ASLO titer increase that proved that any given individual had had the infection in question.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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