Evaluation of a Streptococcal Pharyngitis Score in Southern Taiwan

Shih, Ching‐Tang; Lin, Ching‐Chiang; Lu, Chung-Ching

doi:10.1016/j.pedneo.2011.11.010

Cited by 12 publications

(12 citation statements)

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“…Several studies have been published aiming to elucidate the clinical picture accuracy for the etiological diagnosis of APT in children, with variable results. 7,8,[12][13][14][15] Rimoin et al 16 demonstrated the existence of significant variation in the clinical presentation of APT in four different countries, suggesting it is inadequate to extrapolate conclusions about the clinical picture accuracy from one region to another. Therefore, the importance of the present study is emphasized, conducted in a country where RF and its complications are a major public health problem.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of streptococcal pharyngotonsillitis in children and adolescents: clinical picture limitations

Júnior

Oliveira

Fontes

et al. 2014

Rev. paul. pediatr.

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OBJECTIVE: To assess the utility of clinical features for diagnosis of streptococcal pharyngotonsillitis in pediatrics.METHODS: A total of 335 children aged 1-18 years old and presenting clinical manifestations of acute pharyngotonsillitis (APT) were subjected to clinical interviews, physical examinations, and throat swab specimen collection to perform cultures and latex particle agglutination tests (LPATs) for group A streptococcus (GAS) detection. Signs and symptoms of patients were compared to their throat cultures and LPATs results. A clinical score was designed based on the multivariate logistic regression analysis and also was compared to throat cultures and LPATs results. Positive throat cultures and/or LPATs results were used as a reference standard to establish definitive streptococcal APT diagnosis.RESULTS: 78 children (23.4%) showed positivity for GAS in at least one of the two diagnostic tests. Coryza absence (odds ratio [OR]=1.80; p=0.040), conjunctivitis absence (OR=2.47; p=0.029), pharyngeal erythema (OR=3.99; p=0.006), pharyngeal exudate (OR=2.02; p=0.011), and tonsillar swelling (OR=2.60; p=0.007) were significantly associated with streptococcal pharyngotonsilitis. The highest clinical score, characterized by coryza absense, pharyngeal exudate, and pharyngeal erythema had a 45.6% sensitivity, a 74.5% especificity, and a likelihood ratio of 1.79 for streptococcal pharyngotonsilitis.CONCLUSIONS: Clinical presentation should not be used to confirm streptococcal pharyngotonsilitis, because its performance as a diagnostic test is low. Thus, it is necessary to enhance laboratory test availability, especially of LPATs that allow an acurate and fast diagnosis of streptococcal pharyngotonsilitis.

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Section: Discussionmentioning

confidence: 99%

Diagnosis of streptococcal pharyngotonsillitis in children and adolescents: clinical picture limitations

Júnior

Oliveira

Fontes

et al. 2014

Rev. paul. pediatr.

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“…This is comparable with 11% reported in Turkey 16 ; 12% in Brazil 17 and 9.7% among healthy school children in Ethiopia. 18 But, it was much higher than the prevalence of 2.8%, 4.1% and 7.9%, Taiwan 19 and Indonesia. 20 respectively.…”

Section: Discussionmentioning

confidence: 94%

Is Group a B-Haemolytic Streptococcus Prevalent Among the Children With Tonsillo-Pharyngitis? A School Health Survey Based Study in Pondicherry

A¹

2017

jebmh

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BACKGROUND The morbidity due to Tonsillo-Pharyngitis in children following a Group A Streptococcus (GAS) is very important in ENT practice. It accounts to more than 25% of all the bacterial infections. The aim of this study is to determine the prevalence of Group A Streptococcus (GAS) and their susceptibility to antibiotics in Tonsillo-Pharyngitis patients. MATERIALS AND METHODS 176 children having Tonsillo-Pharyngitis, out of 3086 children surveyed in rural residential schools were included in the study. Demographic and clinical data were recorded in a Proforma. Collected throat swabs were processed with the standard microbiological techniques to isolate GAS. For antimicrobial susceptibility testing disc diffusion method was used. RESULTS Out of 176 students male children were 53 (71.62%) and female were 21 (28.37%) among 5-9 years age (74); 54 (52.94%) and females were 48 (47.05%) among 10-15 years (102). Male-to-female ratio was 1:1.5. Isolates of GAS were susceptible to Penicillins and Clindamycin; 14.20% positive cultures for GAS organism observed. CONCLUSION The overall prevalence of GAS positive culture was 14.20%, which was slightly higher than similar studies all over the world except USA, Tunisia, Yemen and Brazil. In our study, all GAS isolates remained susceptible to penicillin, Ceftriaxone and Clindamycin but showed resistance to Erythromycin.

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“…Clinical characteristics statistically associated with the presence of GAS vary among studies: 7 , 8 , 12 - 15 palatal petechiae; anterior cervical adenopathy; oropharyngeal exudate; sore throat; tonsillar hypertrophy; scarlet fever-like rash, fever >38°C; muscle pain; bad breath; oral ulcers; gastrointestinal symptoms; contact with patients with APT by GAS; age 5 to 12 years; and oropharyngeal erythema appear alone or in different combinations in the several studies. Rhinorrhea, cough, and conjunctivitis usually appear as symptoms associated with viral infection ( p <0.05).…”

Section: Discussionmentioning

confidence: 98%

“…Several studies have been published aiming to elucidate the clinical picture accuracy for the etiological diagnosis of APT in children, with variable results. 7 , 8 , 12 - 15 Rimoin et al 16 demonstrated the existence of significant variation in the clinical presentation of APT in four different countries, suggesting it is inadequate to extrapolate conclusions about the clinical picture accuracy from one region to another. Therefore, the importance of the present study is emphasized, conducted in a country where RF and its complications are a major public health problem.…”

Section: Discussionmentioning

confidence: 99%

“…Diversos estudos já foram publicados no sentido de elucidar a acurácia do quadro clínico para o diagnóstico etiológico das FAA em crianças com resultados variáveis. 7 , 8 , 12 - 15 Rimoin et al 16 demonstraram a existência de importante variação na apresentação clínica da FAA em quatro diferentes países, sugerindo ser incorreto extrapolar as conclusões sobre a acurácia do quadro clínico de uma região para outra. Dessa maneir,a destaca-se a importância do presente trabalho, realizado em um país onde a FR e as suas complicações são um grande problema de saúde pública.…”

Section: Discussionunclassified

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Diagnóstico da faringoamigdalite estreptocócica em crianças e adolescentes: limitações do quadro clínico1

Júnior

Oliveira

Fontes

et al. 2014

Revista Paulista de Pediatria

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OBJECTIVE: To assess the utility of clinical features for diagnosis of streptococcal pharyngotonsillitis in pediatrics. METHODS: A total of 335 children aged 1-18 years old and presenting clinical manifestations of acute pharyngotonsillitis (APT) were subjected to clinical interviews, physical examinations, and throat swab specimen collection to perform cultures and latex particle agglutination tests (LPATs) for group A streptococcus (GAS) detection. Signs and symptoms of patients were compared to their throat cultures and LPATs results. A clinical score was designed based on the multivariate logistic regression analysis and also was compared to throat cultures and LPATs results. Positive throat cultures and/or LPATs results were used as a reference standard to establish definitive streptococcal APT diagnosis. RESULTS: 78 children (23.4%) showed positivity for GAS in at least one of the two diagnostic tests. Coryza absence (odds ratio [OR]=1.80; p=0.040), conjunctivitis absence (OR=2.47; p=0.029), pharyngeal erythema (OR=3.99; p=0.006), pharyngeal exudate (OR=2.02; p=0.011), and tonsillar swelling (OR=2.60; p=0.007) were significantly associated with streptococcal pharyngotonsilitis. The highest clinical score, characterized by coryza absense, pharyngeal exudate, and pharyngeal erythema had a 45.6% sensitivity, a 74.5% especificity, and a likelihood ratio of 1.79 for streptococcal pharyngotonsilitis. CONCLUSIONS: Clinical presentation should not be used to confirm streptococcal pharyngotonsilitis, because its performance as a diagnostic test is low. Thus, it is necessary to enhance laboratory test availability, especially of LPATs that allow an acurate and fast diagnosis of streptococcal pharyngotonsilitis.

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Evaluation of a Streptococcal Pharyngitis Score in Southern Taiwan

Abstract: Pediatric streptococcal pharyngitis in Southern Taiwan is uncommon. Diagnosis of GAS pharyngitis based on the McIsaac sore throat score is unreliable among pediatric patients with febrile pharyngitis in Southern Taiwan.

Cited by 12 publications

References 12 publications

Diagnosis of streptococcal pharyngotonsillitis in children and adolescents: clinical picture limitations

Diagnosis of streptococcal pharyngotonsillitis in children and adolescents: clinical picture limitations

Is Group a B-Haemolytic Streptococcus Prevalent Among the Children With Tonsillo-Pharyngitis? A School Health Survey Based Study in Pondicherry

Diagnóstico da faringoamigdalite estreptocócica em crianças e adolescentes: limitações do quadro clínico1

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