Should We Expand the Pharyngitis Paradigm for Adolescents and Young Adults?
IN RESPONSE: Drs. De Meyere and Matthys presents a rationale for not changing the pharyngitis paradigm for adolescents and young adults. I disagree, but perhaps did not make my point clear enough. Our current paradigm focuses solely on whether patients have group A β-hemolytic streptococcal pharyngitis. I am suggesting that we expand the paradigm to also include F. necrophorum pharyngitis. What are the implications of a new paradigm? We who study pharyngitis have an obligation to learn more about F. necrophorum pharyngitis, to prevent the morbidity and mortality that can occur from that infection. Although we encourage early diagnosis of the Lemierre syndrome, we would rather prevent it. Only through a paradigm change will we collect the appropriate data to understand how to prevent the syndrome. Perhaps we will have better culture techniques, develop rapid tests, or identify the infection on the basis of clinical signs and symptoms. Regardless, expanding the paradigm will refocus our
