Meland et al evaluated patients in general practice with acute tonsillopharyngitis. They looked for clinical findings which could help to identify patients with streptoccoal disease. The authors are from Gade Institute and Haukdeland Hospital in Bergen, Norway.
Patients: children, adolescents and adults
Streptococci included beta-hemolytic Groups A, C and G.
Parameters:
(1) age in years
(2) rubor of pharyngeal wall
(3) swollen lymph nodes
(4) cough
|
Age |
Rubor |
Lymph Nodes |
Cough |
Percent with Strept |
|
< 5 |
N |
N |
N |
low |
|
< 5 |
N |
N |
Y |
low |
|
< 5 |
N |
Y |
N |
low |
|
< 5 |
N |
Y |
Y |
low |
|
< 5 |
Y |
N |
N |
low |
|
< 5 |
Y |
N |
Y |
low |
|
< 5 |
Y |
Y |
N |
20 |
|
< 5 |
Y |
Y |
Y |
low |
|
>= 5 |
N |
N |
N |
33 |
|
>= 5 |
N |
N |
Y |
low |
|
>= 5 |
N |
Y |
N |
25 |
|
>= 5 |
N |
Y |
Y |
14 |
|
>= 5 |
Y |
N |
N |
37 |
|
>= 5 |
Y |
N |
Y |
10 |
|
>= 5 |
Y |
Y |
N |
62 |
|
>= 5 |
Y |
Y |
Y |
32 |
where:
• The patterns marked as "low" had an observed culture rate of 0% and a predicted culture rate of 0.4 to 5%.
|
Findings |
Risk |
|
age <= 5 |
low (10%) |
|
pale pharynx (no rubor) |
low (10%) |
|
coughing and no swollen lymph nodes |
low (10%) |
|
no cough and swollen lymph nodes |
high (62%) |
|
no cough and no swollen lymph nodes |
intermediate (34%) |
|
cough and swollen lymph nodes |
intermediate (34%) |
Specialty: Infectious Diseases, Pedatrics, Otolaryngology
ICD-10: ,
