فارنژیت استرپتوکوکی در کودکان ( بررسی 100 مورد)

This prospective study was designed to find the incidence of streptococcal pharyngitis in childhood sore throat and also to compare the clinical diagnosis of disease with the results of throat cultures. Children, 5 to 15 years of age with sore throat who were seen in pediatric out - patients department formed the subjects of this study. The duration of study was one year (October 1992 - October 1993). There were 443 children with sore throat. 100 patients (22.5%) had positive throat culture (group A Beta hemolytic streptococci) . 53 patients (53%) were male and 47% were female. The mean age of the group was 8.8 ± 3 years. Clinical findings in order of frequency were as follow: redness of pharynx 99% , acute onset of symptoms 86% , fever 84% 1 exudate on tonsils 69% , enlargement and tenderness of anterior cervical lymph nodes 30% , and associated gastrointestinal symptoms 22% . Seasonal prevalence of disease were as follow: spring 35%, winter 34% , autumn 28 % and summer 3%. 53% of this patients had 5 clinical symptoms. 5 clinical findings such as sore throat + fever + acute onset of disease + redness of pharynx + exudate on tonsils and absence of viral symptoms (cough, coryza, conjunctivitis, hoarseness) had a sensitivity of 57% , specititv of 98% J positive predictive value of 89% , negative predictive value of 89% and efficiency of 89%. This study showed that in the absence of laboratory facilities careful clinical findings can be helpful for reaching accurate diagnosis of streptococcal pharyngitis.