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Clinical Trial
. 2009 Jun;36(3):314-20.
doi: 10.1016/j.anl.2008.07.001. Epub 2008 Sep 5.

A scoring system for management of acute pharyngo-tonsillitis in adults

Masaki Suzumoto  1 , Muneki Hotomi, Dewan S Billal, Keiji Fujihara, Yasuaki Harabuchi, Noboru Yamanaka
Affiliations
Clinical Trial

A scoring system for management of acute pharyngo-tonsillitis in adults

Masaki Suzumoto et al. Auris Nasus Larynx. 2009 Jun.

Abstract

Objectives: The aim of this study was to develop and evaluate a scoring system for the management of acute pharyngo-tonsillitis.

Methods: We conducted a prospective study between May 2004 and June 2005. Patients with acute pharyngo-tonsillitis were evaluated for causative pathogens and were assessed clinical symptoms and pharyngo-tonsillar finding by a clinical scoring system.

Results: A total 214 adult patients were enrolled in this study. Streptococcus pyogenes were identified at 13.6%. Thirty-one viruses were also identified by PCR. They were adenovirus (4.8%), influenza virus (1.0%), RS virus (6.3%), and human metapneumovirus (2.9%). Numbers of total white blood cells and levels of C-reactive protein showed a significant positive correlation with clinical scores (p<0.001) and were also higher in cases with S. pyogenes. The clinical scores rapidly improved after the antimicrobial treatments in moderate cases and severe cases.

Conclusion: The current study strongly suggested that the clinical scoring system reflected disease severity well and would be very useful for evaluating clinical course and decision making for the antimicrobial treatment of acute pharyngo-tonisllitis.

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Figures

Fig. 1
Fig. 1
Distributions of clinical scores, total WBC counts, and serum levels of CRP in patients with S. pyogenes or other pathogens. Figures show maximum, 75% value, median, 25% value and minimum. The p-values are analyzed by Tukey–Kramer analysis.
Fig. 2
Fig. 2
Correlation between clinical scores and total WBC counts. Each circle shows cases. r = 0.482, y = 695.6x + 5734.6, p < 0.001.
Fig. 3
Fig. 3
Correlation between clinical scores and serum levels of CRP. Each circle shows cases. r = 0.571, y = 1.1x ± 2.4, p < 0.001.
Fig. 4
Fig. 4
Clinical outcomes of acute pharyngo-tonsillitis depending on the severity of the disease: (a) clinical symptoms and (b) pharyngo-tonsillar findings, figures show maximum, 75% value, median, 25% value and minimum. The p-values are analyzed by Wilcoxon signed-rank test.
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