A streptococcal score card revisited.

Abstract:

OBJECTIVE:To evaluate the utility of a simple scoring system as a predictor of obtaining a positive throat culture for group A streptococci (GAS). DESIGN:Prospective descriptive study. Scores were assigned prior to the availability of the results of throat cultures. SETTING:Emergency department and walk-in clinic of the Children's Hospital of Pittsburgh. PATIENTS:Patients were 365 children between the ages of two and 16 years with acute onset of sore throat and a history of or documentation of fever within the preceding 24 hours. INTERVENTIONS:A streptococcal score was assigned on the basis of a 6-point schema in which the features were 1) age; 2) season; 3) temperature of at least 38.3 degrees C; 4) adenopathy; 5) pharyngeal erythema, edema, or exudate; and 6) no symptoms of a viral upper respiratory infection (conjunctivitis, rhinorrhea, or cough). A throat culture was performed for the isolation of GAS. MAIN OUTCOME MEASURE:Positive predictive value of the streptococcal score in identifying children with a positive throat culture for GAS. RESULTS:A score of 5 or 6 predicted a positive culture for GAS in 59 and 75% of children, respectively. In patients with evidence of acute pharyngitis, the combination of age between five and 15 years, fever and absence of upper respiratory symptoms predicted a positive culture for GAS in 72% of patients. CONCLUSIONS:The score can be used to predict the likelihood that a throat culture will be positive for GAS.

journal_name

Pediatr Emerg Care

journal_title

Pediatric emergency care

authors

Wald ER,Green MD,Schwartz B,Barbadora K

doi

10.1097/00006565-199804000-00005

subject

Has Abstract

pub_date

1998-04-01 00:00:00

pages

109-11

issue

2

eissn

0749-5161

issn

1535-1815

journal_volume

14

pub_type

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