Rare Diseases Symptoms Automatic Extraction
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Reflexive culture in adolescents and adults with group a streptococcal pharyngitis.
[acute rheumatic fever]
Guidelines
currently
provide
conflicting
recommendations
regarding
the
diagnosis
of
group
A
streptococcal
(
GAS
)
pharyngitis
in
adults
.
Clinical
guidelines
state
that
negative
rapid
antigen
detection
tests
(
RADTs
)
do
not
require
confirmation
by
a
backup
method
in
adults
,
whereas
laboratory-based
guidelines
mandate
confirmation
of
a
negative
RADT
in
patients
of
all
ages
.
The
objective
of
this
study
was
to
assess
the
utility
of
reflexive
culture
following
a
negative
RADT
in
adolescents
and
adults
with
suspected
GAS
pharyngitis
.
A
retrospective
analysis
of
726
patients
,
aged
≥
13
years
,
with
negative
RADTs
and
positive
GAS
throat
cultures
,
was
performed
between
1
January
2000
and
31
December
2011
at
2
academic
medical
centers
in
Seattle
,
Washington
.
Complication
rates
,
treatment
,
modified
Centor
score
,
and
bacterial
burden
in
patients
with
negative
RADTs
and
positive
GAS
throat
cultures
were
assessed
.
Modified
Centor
scores
≥
2
were
observed
in
55
%
of
patients
with
a
negative
RADT
and
positive
GAS
culture
.
Of
these
,
77
%
of
patients
had
a
moderate
or
heavy
bacterial
burden
(
≥
2
+
)
.
RADTs
failed
to
detect
some
patients
who
presented
with
serious
complications
of
GAS
pharyngitis
:
29
(
4
.
0
%
)
had
peritonsillar
abscesses
and
2
(
0
.
28
%
)
were
diagnosed
with
acute
rheumatic
fever
.
Providers
found
culture
results
to
be
useful
for
initiating
antibiotic
therapy
or
confirming
a
clinical
diagnosis
.
Antibiotic
treatment
was
prescribed
in
68
.
7
%
of
patients
,
with
culture-directed
initiation
of
therapy
documented
in
43
.
5
%
.
Reflexive
GAS
culture
is
clinically
useful
when
RADTs
are
negative
.
RADTs
fail
to
detect
a
substantial
number
of
adult
patients
with
clinically
significant
pharyngitis
who
can
benefit
from
treatment
.
Diseases
Validation
Diseases presenting
"fever"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
alexander disease
allergic bronchopulmonary aspergillosis
canavan disease
carcinoma of the gallbladder
child syndrome
congenital toxoplasmosis
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
esophageal adenocarcinoma
esophageal carcinoma
familial mediterranean fever
focal myositis
hodgkin lymphoma, classical
lamellar ichthyosis
legionellosis
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
papillon-lefèvre syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
wolf-hirschhorn syndrome
This symptom has already been validated