Streptococcal pharyngitis in a paediatric emergency department

Edmond, K.M., Grimwood, K., Carlin, J.B., Chondros, P., Hogg, G.G. and Barnett, P.L.J. (1996) Streptococcal pharyngitis in a paediatric emergency department. Medical Journal of Australia, 165 8: 420-423.

Author Edmond, K.M.
Grimwood, K.
Carlin, J.B.
Chondros, P.
Hogg, G.G.
Barnett, P.L.J.
Title Streptococcal pharyngitis in a paediatric emergency department
Journal name Medical Journal of Australia   Check publisher's open access policy
ISSN 0025-729X
Publication date 1996-10
Sub-type Article (original research)
Open Access Status Not yet assessed
Volume 165
Issue 8
Start page 420
End page 423
Total pages 4
Place of publication Strawberry Hills, Australia
Publisher Australasian Medical Publishing Company
Language eng
Formatted abstract
Objective: To determine the prevalence and clinical features of β-haemolytic streptococcal infection in children with acute pharyngitis and thereby to define those requiring antibiotic therapy. Design: Prospective 2:1 case-control study. Setting: Emergency Medicine Department of the Royal Children's Hospital, Melbourne, between May 1994 and May 1995. Participants: Cases (n = 271) were the first 10 self-referred children in each week with pharyngitis and no antibiotic use in the previous week. Controls (n = 135) were age-matched children without infection. Main outcome measures: Presence of groups A, C or G β-haemolytic streptococci in oropharyngeal cultures; demographic and clinical characteristics. Results: Group A β-haemolytic streptococci (GABHS) were isolated from significantly more case than control children (cases, 57/271 [21%]; controls, 9/135 [7%]; odds ratio [OR], 3.7; P < 0.001). Groups C and G β-haemolytic streptococci were isolated from 10 (4%) and 5 (2%) case children, respectively, but not from controls. Age ≤ 4 years, tender cervical lymph nodes, pharyngotonsillitis, absent coryza and scarlatiniform rash were significantly associated with GABHS (P < 0.02). GABHS was uncommon in children aged < 4 years (4%), but was present in 12 of 14 children ≤ 4 years with a rash (86%). However, most cases lacked a rash, and for children ≤ 4 years likelihood of GABHS varied from 10%-65%, depending on other clinical features. Conclusions: In children aged < 4 years, GABHS is an unlikely cause of acute pharyngitis and symptomatic treatment alone should be considered. In children ≤ 4 years, the likelihood of GABHS being the cause of acute pharyngitis increases with presence of scarlatiniform rash, pharyngotonsillitis and tender cervical nodes.
Keyword Managing sore throat
Cost effectiveness
Carrier state
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: Child Health Research Centre Publications
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 18 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 0 times in Scopus Article
Google Scholar Search Google Scholar
Created: Thu, 20 Oct 2011, 11:24:03 EST by System User on behalf of Learning and Research Services (UQ Library)