Clinical features predicting group A streptococcal pharyngitis in a Japanese paediatric primary emergency medical centre

Masahiro Nishiyama, Ichiro Morioka, Mariko Taniguchi-Ikeda, Takeshi Mori, Kazumi Tomioka, Keita Nakanishi, Junya Fujimura, Noriyuki Nishimura, Kandai Nozu, Hiroaki Nagase, Kazuto Ishibashi, Akihito Ishida, Kazumoto Iijima

Research output: Contribution to journalArticle

Abstract

Objectives: To identify clinical features that predict Group A streptococcal (GAS) pharyngitis in a Japanese paediatric primary emergency medical centre. Methods: The prevalence of GAS pharyngitis according to age and body temperature (BT) was calculated among 3098 paediatric patients with pharyngitis. The numbers of GAS-positive and -negative patients for each clinical parameter, and each point increase in the McIsaac score were compared and likelihood ratios (LRs) were calculated. Results: The prevalence of GAS pharyngitis was extremely low in patients aged < 1 (1.2%) and 1 year (3.9%). The GAS-positive rate was significantly higher in patients with a BT < 38.0°C compared with ≥ 38.0°C (30.0% vs. 19.8%). A BT ≥ 38.0°C was not a predictive finding for GAS pharyngitis (positive LR: 0.82). Rash was the most useful individual predictor, and a McIsaac score of 4 or 5 increased the probability; however, the positive LRs were 1.74 and 1.30, respectively. Conclusions: The prevalence of GAS pharyngitis is extremely low in patients aged < 1 and 1 year, and a BT ≥ 38.0°C is not a predictive symptom. Although a rash and McIsaac score of 4 or 5 are associated with an increased probability, they cannot be used to confirm GAS infection.

Original languageEnglish
Pages (from-to)1791-1800
Number of pages10
JournalJournal of International Medical Research
Volume46
Issue number5
DOIs
Publication statusPublished - 01-05-2018

All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Cell Biology
  • Biochemistry, medical

Fingerprint Dive into the research topics of 'Clinical features predicting group A streptococcal pharyngitis in a Japanese paediatric primary emergency medical centre'. Together they form a unique fingerprint.

Cite this