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Alternative diagnostic method for streptococcal pharyngitis: Breese scoring system.

B Ulukol1, A Günlemez, D Aysev

  • 1Department of Pediatrics, Ankara University Faculty of Medicine, Turkey.

The Turkish Journal of Pediatrics
|August 11, 2000
PubMed
Summary

The Breese scoring system effectively diagnoses streptococcal pharyngitis in children over three years old. It is less reliable for diagnosing strep throat in younger children aged three and under.

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Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Diagnostic Accuracy

Background:

  • Acute pharyngitis is a common pediatric illness.
  • Group A beta-hemolytic streptococci (GABHS) are a frequent cause of bacterial pharyngitis.
  • Accurate diagnosis is crucial to prevent complications and unnecessary antibiotic use.

Purpose of the Study:

  • To evaluate the diagnostic effectiveness of the Breese scoring system for streptococcal pharyngitis.
  • To compare the system's performance across different pediatric age groups.

Main Methods:

  • Two hundred and two children aged three years and younger (Group 1) and 514 children over three years old (Group 2) with acute pharyngitis were enrolled.
  • Patients underwent clinical evaluation using the Breese scoring system and throat-swab cultures for GABHS.

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  • Sensitivity, specificity, and predictive values were calculated for each age group.

    • Main Results:

    • In Group 1 (≤3 years), Breese scores did not significantly differentiate between positive and negative GABHS cultures.
    • In Group 2 (>3 years), mean Breese scores were significantly higher in patients with positive GABHS cultures.
    • Diagnostic performance metrics (sensitivity, positive predictive value, negative predictive value) were superior in Group 2 compared to Group 1.

    Conclusions:

    • The Breese scoring system is a helpful diagnostic tool for streptococcal pharyngitis in children over three years of age.
    • Its diagnostic utility is limited in children aged three years and younger.
    • Age stratification is important when utilizing the Breese scoring system for diagnosing strep throat.