Clinical Application of a Scoring System in the Diagnosis of Group A Streptococcal Pharyngitis.
- Author:
Hyeon Bu KIM
1
;
Byung Soo CHO
;
Sung Ho CHA
;
Jeong Hun HA
;
Sun Hee KIM
;
Gui Sook CHOI
Author Information
1. Department of Pediatrics, College of Medicine, Kyung-Hee University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Scoring system;
Pharyngitis;
Group A streptococci;
Throat culture
- MeSH:
Anti-Bacterial Agents;
Diagnosis*;
Fever;
Humans;
Pharyngitis*;
Pharynx;
Sensitivity and Specificity
- From:Journal of the Korean Pediatric Society
1998;41(10):1365-1371
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: A scoring system could be clinically useful in determining cases in which a throat culture may be omitted or in cases whether antibiotics may be initiated or not. We propose to make a clinical guideline of antibiotics administration in patients with pharyngitis. METHODS: From Apr. 1996. to Mar. 1997, throat cultures were taken from 321 cases (72 cases from Kyung-Hee Medical Center, 249 cases from 3 local pediatric clinics). On the first day of visit, 9 clinical items on a score-card were checked and a tentative diagnosis for streptococcal or non-streptococcal infection was made. These clinical scores were compared with the results of the throat swab cultures. RESULTS: Of 321 cases with pharyngitis, 55 cases (17%) proved to have group A streptococci by throat culture. The positive culture rate of group A streptococci was 18.5% from 3 local pediatric clinics, and 12.5% from Kyung-Hee Medical Center. The positive culture rate of group A streptococci were 40% in above 31 points of score, 31.5% in 29 to 30 points, 20.5% in 27 to 28 points. The sensitivity and specificity of the scoring system using a score at least 28 above points were 71% and 67%, respectively. CONCLUSION: The clinical diagnosis of streptococcal pharyngitis indicates that patients age 5 to 10 years, findings of abnormal pharynx, high fever and no past history of antibiotics use. Further modification of the scoring system for diagnosis of streptococcal pharyngitis should be made to prevent antibiotics abuse and correct diagnosis of pharyngitis.
