SGA is a benign inflammatory skin lesion that should be considered in the differential diagnosis of a subcutaneous nodule(s) of the scalp and/or distal extremities of an otherwise healthy child. Because the nodule(s) are benign and may recur with or without surgical biopsy, reassurance is the best management.
Despite various task force recommendations, PHS performance rates are generally suboptimal in varied clinic settings, including those of resident practices in teaching hospitals. Physicians and residents believe in the importance of health maintenance but fall short of their ideal in practice. Interventions to improve performance rates have been described; we are detailing a simple, inexpensive, and practical method that achieved positive results.
Penicillin V, benzathine/procaine penicillin G, cefadroxil monohydrate, and erythromycin estolate were randomly assigned for therapy of group A streptococcal pharyngitis in 198 children. All patients improved with in 24 hours of initiating therapy. Reinfection with a new group A streptococcal serotype occurred in 13 patients, 12 developing 7 to 12 days after stopping therapy and 11 becoming symptomatic. Relapse with the same organism occurred in 16 patients, only 5 (31%) of whom were symptomatic. Antibody titer rises, antibiotic resistance of group A organisms, presence of penicillinase-producing staphylococci, and lack of compliance were not related to recurrent infections. There were no significant differences between the failure rates of the four test drugs: penicillin V, 12%; benzathine/procaine penicillin G, 12%; cefadroxil monohydrate, 5%; and erythromycin, 2%.
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