A 10-Year-Old Boy Is Brought to the Office Due to Abrupt

A 10-year-old boy is brought to the office due to abrupt onset fever and sore throat that began a day ago.  He has had similar illnesses in the past, which were treated with oral antibiotics.  The patient has no other medical conditions and has received all recommended vaccinations.  Temperature is 38.3 C (101 F) .  Physical examination shows erythema of the posterior pharyngeal wall and enlarged tonsils, which are covered by white exudate.  There are no enlarged cervical lymph nodes.  Throat swab specimen is obtained.  Which of the following would be most helpful in determining the need for antibiotic treatment in this patient?

A) Gram staining of the swab for gram-positive cocci in chains
B) Serum titer assay for anti-M protein antibodies
C) Serum titer assay for anti-streptolysin O antibodies
D) Swab culture to demonstrate colonies with incomplete hemolysis
E) Swab immunoassay for streptococcal group A antigens

Correct Answer:

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