Original Articles Prediction of bacterial pharyngitis in children using clinical features

Ethar M. Malik, Sulafa KM Ali


Background: Bacterial pharyngitis (BPh) is a common paediatric problem that can lead to serious long term
cardiovascular complications: Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) constitute
significant public health problems in Sudan. Primary prevention of ARF requires prompt diagnosis and
antibiotic treatment of group A streptococcal (GAS) pharyngitis, the commonest pathogen causing BPh.
Materials and Methods: The study is a prospective descriptive cross sectional hospital based study
describing the clinical features of GAS pharyngitis and comparing them with throat culture results. The
study was conducted in the period December 2011 to July 2012 in the Children’s Hospital outpatient clinics.
Children between 5 and 15 years of age who had sore throat and pharyngeal erythema without cough or
runny nose were enrolled in the study. Clinical and demographic information was recorded and throat
culture was done. Sensitivity and specificity were estimated for each clinical feature.
Results: Out of 220 children with pharyngitis, 81 (36.8%) had positive throat culture, 28.2% were due
to GAS. Headache was the only symptom that correlated with culture positive GAS pharyngitis with a
(p-value = 0.001) and the significant sign is the absence of chest findings (p-value=0.005). Fever and
enlarged cervical nodes were 91%, and 88% sensitive, for positive GAS culture, respectively. None of the
clinical features had both high sensitivity and specificity.
Conclusion: Fever, absence of chest findings, headache and enlarged cervical nodes can be used in 5-15
years old children with sore throat as clinical indicators of GAS pharyngitis. However, we need to have a
low threshold to give antibiotics to patients with sore throat living in areas endemic for RHD.


Original Articles ;Prediction of ;bacterial ;pharyngitis in; children using ;clinical; features

Full Text:



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