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

研究成果: Article

抄録

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.

元の言語English
ページ(範囲)1791-1800
ページ数10
ジャーナルJournal of International Medical Research
46
発行部数5
DOI
出版物ステータスPublished - 01-05-2018

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Pediatrics
Pharyngitis
Emergencies
Body Temperature
Exanthema
Temperature
Streptococcal Infections

All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Cell Biology
  • Biochemistry, medical

これを引用

Nishiyama, Masahiro ; Morioka, Ichiro ; Taniguchi-Ikeda, Mariko ; Mori, Takeshi ; Tomioka, Kazumi ; Nakanishi, Keita ; Fujimura, Junya ; Nishimura, Noriyuki ; Nozu, Kandai ; Nagase, Hiroaki ; Ishibashi, Kazuto ; Ishida, Akihito ; Iijima, Kazumoto. / Clinical features predicting group A streptococcal pharyngitis in a Japanese paediatric primary emergency medical centre. :: Journal of International Medical Research. 2018 ; 巻 46, 番号 5. pp. 1791-1800.
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title = "Clinical features predicting group A streptococcal pharyngitis in a Japanese paediatric primary emergency medical centre",
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.",
author = "Masahiro Nishiyama and Ichiro Morioka and Mariko Taniguchi-Ikeda and Takeshi Mori and Kazumi Tomioka and Keita Nakanishi and Junya Fujimura and Noriyuki Nishimura and Kandai Nozu and Hiroaki Nagase and Kazuto Ishibashi and Akihito Ishida and Kazumoto Iijima",
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Nishiyama, M, Morioka, I, Taniguchi-Ikeda, M, Mori, T, Tomioka, K, Nakanishi, K, Fujimura, J, Nishimura, N, Nozu, K, Nagase, H, Ishibashi, K, Ishida, A & Iijima, K 2018, 'Clinical features predicting group A streptococcal pharyngitis in a Japanese paediatric primary emergency medical centre', Journal of International Medical Research, 巻. 46, 番号 5, pp. 1791-1800. https://doi.org/10.1177/0300060517752954

Clinical features predicting group A streptococcal pharyngitis in a Japanese paediatric primary emergency medical centre. / Nishiyama, Masahiro; Morioka, Ichiro; Taniguchi-Ikeda, Mariko; Mori, Takeshi; Tomioka, Kazumi; Nakanishi, Keita; Fujimura, Junya; Nishimura, Noriyuki; Nozu, Kandai; Nagase, Hiroaki; Ishibashi, Kazuto; Ishida, Akihito; Iijima, Kazumoto.

:: Journal of International Medical Research, 巻 46, 番号 5, 01.05.2018, p. 1791-1800.

研究成果: Article

TY - JOUR

T1 - Clinical features predicting group A streptococcal pharyngitis in a Japanese paediatric primary emergency medical centre

AU - Nishiyama, Masahiro

AU - Morioka, Ichiro

AU - Taniguchi-Ikeda, Mariko

AU - Mori, Takeshi

AU - Tomioka, Kazumi

AU - Nakanishi, Keita

AU - Fujimura, Junya

AU - Nishimura, Noriyuki

AU - Nozu, Kandai

AU - Nagase, Hiroaki

AU - Ishibashi, Kazuto

AU - Ishida, Akihito

AU - Iijima, Kazumoto

PY - 2018/5/1

Y1 - 2018/5/1

N2 - 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.

AB - 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.

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