[Evaluation of clinical data and a technique of rapid detection (TestPack Strep A) in the diagnosis of acute streptococcal pharyngo-tonsillitis]

Abstract

We have evaluated the validity of the clinical data, the clinical impression (CI) of the physician and a rapid antigenic technique (RAT) for the diagnosis of acute streptococcal pharyngitis and tonsillitis (SPT). We evaluated 126 patients aged 7-60 years (October 1988-March 1989). The incidence of SPT was 19%. SPTs had a significantly higher frequency of lack of cough and sudden onset as isolated findings, and of the associations fever greater than 38 degrees C + exudate + lack of cough, and sudden onset + fever greater than 38 degrees C + exudate + lack of cough. CI had a sensibility (S) of 56%, a specificity (Sp) of 72%, a positive predictive value (PPV) of 32%, a negative predictive value (NPV) of 88% and an overall valve (OV) of 69%. The RAT had a S of 79.2%, a Sp 93%, a PPV of 73%, a NPV of 95%, and an OV of 90.5%. Only some clinical data are useful to diagnose SPT. The CI of the physician has a low predictive value, whereas TestPack Strep A is useful and has a similar value as pharyngeal culture.