Accuracy and Precision of the Signs and Symptoms of Streptococcal Pharyngitis in Children: A Systematic Review - 12/02/12
, Nithya Swaminathan, MD 2, Emma G. Hooper, BA 1
Reprint requests: Nader Shaikh, MD, MPH, Children’s Hospital of Pittsburgh, General Academic Pediatrics, One Children’s Hospital Drive, 4401 Penn Ave, Pittsburgh, PA 15224.Abstract |
Objective |
To conduct a systematic review to determine whether clinical findings can be used to rule in or to rule out streptococcal pharyngitis in children.
Study design |
Two authors independently searched MEDLINE and EMBASE. We included articles if they contained data on the accuracy of symptoms or signs of streptococcal pharyngitis, individually or combined into prediction rules, in children 3-18 years of age.
Results |
Thirty-eight articles with data on individual symptoms and signs and 15 articles with data on prediction rules met all inclusion criteria. In children with sore throat, the presence of a scarlatiniform rash (likelihood ratio [LR], 3.91; 95% CI, 2.00-7.62), palatal petechiae (LR, 2.69; CI, 1.92-3.77), pharyngeal exudates (LR, 1.85; CI, 1.58-2.16), vomiting (LR, 1.79; CI, 1.58-2.16), and tender cervical nodes (LR, 1.72; CI, 1.54-1.93) were moderately useful in identifying those with streptococcal pharyngitis. Nevertheless, no individual symptoms or signs were effective in ruling in or ruling out streptococcal pharyngitis.
Conclusions |
Symptoms and signs, either individually or combined into prediction rules, cannot be used to definitively diagnose or rule out streptococcal pharyngitis.
Le texte complet de cet article est disponible en PDF.Mots-clés : GAS, LR
Plan
| The authors declare no conflicts of interest. |
Vol 160 - N° 3
P. 487 - mars 2012 Retour au numéro
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