J Korean Pediatr Soc.  1998 Oct;41(10):1365-1371.

Clinical Application of a Scoring System in the Diagnosis of Group A Streptococcal Pharyngitis

• Kim HB
• Cho BS
• Cha SH
• Ha JH
• Kim SH
• Choi GS

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.

Keyword

Scoring system; Pharyngitis; Group A streptococci; Throat culture

MeSH Terms

Anti-Bacterial Agents
Diagnosis*
Fever
Humans
Pharyngitis*
Pharynx
Sensitivity and Specificity
Anti-Bacterial Agents