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
1326-5377
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
Management
Diagnosis
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
 
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