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. 2017 Apr-Jun;9(2):116-120.
doi: 10.4103/0974-2727.199635.

A clinical decision rule for streptococcal pharyngitis management: An update

Hosain Nasirian  1 , Saeedeh TarvijEslami  1 , Esfandiar Matini  1 , Seyedehsara Bayesh  2 , Yasaman Omaraee  3
Affiliations

A clinical decision rule for streptococcal pharyngitis management: An update

Hosain Nasirian et al. J Lab Physicians. 2017 Apr-Jun.

Abstract

Purpose: Group A streptococcal (GAS) pharyngitis is a common disease worldwide. We aimed to establish a pragmatic program as a clinical decision rule for GAS pharyngitis diagnosis.

Materials and methods: This article derived from a research project on children aged 6-15 years. Five hundred and seventy-one children met the enrollment criteria on whom throat culture and validities of clinical findings were assessed in positive and negative throat culture groups.

Results: Positive GAS throat culture group included 99 (17.3%) patients with a positive culture. Negative GAS throat culture group included 472 (82.6%) patients. Exudate or enlarged tender nodes each one had 63% and 68% sensitivity and 31.5% and 37.5% specificity with a high percentage of negative predictive value (NPV) 80.54% and 85.09%, respectively. Sequence test revealed validities of exudate plus enlarged nodes at 43.62% sensitivity and 57.19% specificity with 83% NPV.

Conclusions: High NPV of 83% indicated that similar prevalence in the absence of either exudate or enlarged tender lymph nodes. Probability of GAS negative throat cultures among children suspected of GAS pharyngitis was 83% and would correctly not receive inopportune antibiotics.

Keywords: Erythema; exudate; lymph nodes; pharyngitis; streptococcal.

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Conflict of interest statement

There are no conflicts of interest.

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