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Acute exudative tonsillitis in adults: the use of the Centor scoreand some laboratory tests
Yavuz Furuncuoğlu1, Filiz Sağlam2, Ahmet Kutluhan3
1Department of Internal Medicine, Faculty of Medicine, Bahçeşehir University, Göztepe Medical Park Hospital, İstanbul, Turkey.
Insights
The Centor score, C-reactive protein (CRP), neutrophilia, and lymphocytopenia can help diagnose Group A beta-hemolytic streptococcus (GABHS) tonsillitis. A Centor score of 3 or higher with these lab findings predicts GABHS pharyngitis.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Diagnostics
Background:
- Exudative tonsillitis diagnosis requires differentiating Group A beta-hemolytic streptococcus (GABHS) from other causes.
- Accurate diagnosis is crucial for appropriate antibiotic treatment and preventing complications.
Purpose of the Study:
- To evaluate the diagnostic utility of the Centor score and basic laboratory tests for GABHS exudative tonsillitis.
- To differentiate GABHS from non-GABHS causes of tonsillitis.
Main Methods:
- Retrospective analysis of clinical and laboratory data from 899 adult patients with exudative tonsillitis.
- Statistical comparison of patient characteristics based on GABHS throat culture results.
Main Results:
- GABHS was identified in 6.2% of patients; other bacterial causes in 3.8%.
- Patients with GABHS tonsillitis showed significantly higher Centor scores (≥3), neutrophilia, lymphocytopenia, and elevated C-reactive protein (CRP) levels (>5x upper limit).
Conclusions:
- A Centor score of 3 or more, combined with neutrophilia, lymphocytopenia, and elevated CRP, is predictive of GABHS tonsillopharyngitis.
- These clinical and laboratory markers aid in the differential diagnosis of bacterial tonsillitis.
Background/Aim:
The aim of our study was to determine the usefulness of the Centor score and some basic laboratory tests (complete blood count and C-reactive protein) for the differential diagnosis of exudative tonsillitis due to Group A β-hemolytic streptococcus (GABHS) or due to non-GABHS agents.
Materials And Methods:
The data of clinical and laboratory characteristics of the patients diagnosed with exudative tonsillitis were collected and statistically compared between those having positive GABHS throat culture result and those who were negative for any bacterial agent.
Results:
Totally 899 adult patients were included in our study; 56 (6.2%) of them were positive for GABHS, while 34 (3.8%) of the cases had a bacterial cause other than GABHS. The remaining 809 (90%) were accepted as non-GABHS cases. The percentages of patients having Centor score of 3 or greater, neutrophilia, lymphocytopenia, and CRP values of greater than 5-fold normal upper reference range were significantly higher in GABHS patients.
Conclusion:
Centor score of 3 or more together with high CRP, neutrophilia, and lymphocytopenia is predictive for GABHS tonsillopharyngitis.
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