Group A beta-hemolytic streptococcal pharyngitis in preschool children aged 3 months to 5 years

The authors describe a prospective study of 420 patients aged 3 months to 5 years who presented to a primary pediatric clinic owing to fever greater t han or equal to 38 degrees C and signs of pharyngitis and were not treated with antibiotics in the preceding week. Thr oat cultures and blood antistre ptolysin O (ASO) titers were examined. In group A beta-hemolytic streptococ cus (GABHS)-positive patients, a second ASO sample was obtained 2-3 weeks l ater. Positive thr oat cultures to GABHS were found in 61 of 415 patients ( 14.7%) (five patients were lost to follow-up). Thirty-three of these (54.1% of the culture-positive group and 8% of the total study group) had the str eptococcal infection with elevated ASO titers. The incidence of both true i nfection and carrier state gradually increased with age. Nevertheless, true streptococcal pharyngitis was found even in patients younger than 1 year a nd its percentage related to carriers did not increase with age and was gre ater than or equal to 50% in all age groups up to 4 years. The authors conc lude that true GABHS pharyngitis may present in the first year of life.