Sore Throat: Avoid Overcomplicating the Uncomplicated
Authors: Robert M. Centor, T. Prescott Atkinson, Carlos Estrada, Ken B. Waites
Journal: Annals of Internal Medicine (2015)

Letters16 June 2015Sore Throat: Avoid Overcomplicating the UncomplicatedRobert M. Centor, MD, T. Prescott Atkinson, MD, Carlos Estrada, MD, and Ken B. Waites, MDRobert M. Centor, MDFrom University of Alabama at Birmingham, Birmingham, Alabama.Search for more papers by this author, T. Prescott Atkinson, MDFrom University of Alabama at Birmingham, Birmingham, Alabama.Search for more papers by this author, Carlos Estrada, MDFrom University of Alabama at Birmingham, Birmingham, Alabama.Search for more papers by this author, and Ken B. Waites, MDFrom University of Alabama at Birmingham, Birmingham, Alabama.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5100 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Linder (1) discounts the possibility that Fusobacterium necrophorum causes pharyngitis and proposes that, even if it does, we should not assume that treating this condition would prevent suppurative complications (especially the Lemierre syndrome). He argues that we should stick to a simple strategy of using the Centor score to reassure some patients (those with scores of 0 or 1) and use a rapid streptococcus test for the remaining patients, treating only those with positive rapid test results. He asserts that we should not complicate the diagnosis and treatment decisions.We strongly disagree. Although preadolescent sore throat is ...References1. Linder JA. Sore throat: avoid overcomplicating the uncomplicated [Editorial]. Ann Intern Med. 2015;162:311-2. [PMID: 25686170] doi:10.7326/M14-2899 LinkGoogle Scholar2. Centor RM, Geiger P, Waites KB. Fusobacterium necrophorum bacteremic tonsillitis: 2 cases and a review of the literature. Anaerobe. 2010;16:626-8. [PMID: 20813196] doi:10.1016/j.anaerobe.2010.08.005 CrossrefMedlineGoogle Scholar3. Centor RM, Atkinson TP, Ratliff AE, Xiao L, Crabb DM, Estrada CA, et al. The clinical presentation of Fusobacterium-positive and streptococcal-positive pharyngitis in a university health clinic: a cross-sectional study. Ann Intern Med. 2015;162:241-7. [PMID: 25686164] doi:10.7326/M14-1305 LinkGoogle Scholar4. Centor RM. Expand the pharyngitis paradigm for adolescents and young adults. Ann Intern Med. 2009;151:812-5. [PMID: 19949147] doi:10.7326/0003-4819-151-11-200912010-00011 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Alabama at Birmingham, Birmingham, Alabama.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOf InterestForms.do?msNum=L15-0186. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSore Throat: Avoid Overcomplicating the Uncomplicated Jeffrey A. Linder Sore Throat: Avoid Overcomplicating the Uncomplicated Jeffrey A. Linder Sore Throat: Avoid Overcomplicating the Uncomplicated Jeffrey A. Linder Sore Throat: Avoid Overcomplicating the Uncomplicated Jeffrey A. Linder Metrics Cited byThe long shadow of Lemierre’s syndrome 16 June 2015Volume 162, Issue 12Page: 878KeywordsAntibioticsHIV infectionsPenicillinPharyngitisPolymerase chain reactionRheumatic feverStreptococcal infectionsStreptococcusStreptococcus pyogenesYoung adults ePublished: 16 June 2015 Issue Published: 16 June 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...