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Volume 350:2622-2623 June 17, 2004 Number 25
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A Pain in the Neck

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 by Bliss, S. J.
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To the Editor: In the Clinical Problem-Solving article by Bliss et al. (March 4 issue),1 which involved a case of Lemierre's syndrome, the discussant mentions that the patient's "tonsillar exudates, fever, anterior cervical adenopathy, and absence of cough . . . are highly suggestive of streptococcal pharyngitis" and that "a swab from her pharynx for a rapid streptococcal-antigen test" should be obtained. Recent guidelines and studies have suggested that such patients (those whose condition satisfies all four Centor criteria) can be treated empirically for streptococcal pharyngitis without the need for further testing.2,3 Although the organism usually involved in Lemierre's syndrome, . . . [Full Text of this Article]


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