ABSTRACT
Guidelines for the diagnosis and management of patients with acute group A streptococcal pharyngitis have changed little in the half century since recommendations were initially described. Several authoritative scientific bodies have issued guidelines recently for primary rheumatic fever prophylaxis.6-8
The principles involved include timely diagnosis utilising the clinical microbiology laboratory whenever possible to confirm the presence of group A streptococci. Clinical diagnosis is often difficult. Whereas the throat culture remains the ‘gold standard’ for determining the presence of group A streptococci in the upper respiratory tract, new rapid antigen detection techniques that require only 10-20 minutes are commercially available. Their specificity exceeds the sensitivity of these rapid tests, and many experts agree that the presence of a negative rapid test is cause for a back-up throat culture.
