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Acute Pharyngitis01:30

Acute Pharyngitis

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Tonsillitis II: Management01:26

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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Capsular Serotyping of Streptococcus pneumoniae by Latex Agglutination
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Rapid strep testing in children with recently treated streptococcal pharyngitis.

Amin J Barakat1, Coni Evans2, Monica Gill3

  • 1Georgetown University Medical Center Washington DC USA.

Pediatric Investigation
|August 28, 2020
PubMed
Summary

Rapid antigen-detection tests (RADTs) show a higher false positive rate in children recently treated for group A Streptococcus (GAS) pharyngitis. Throat cultures are recommended for these children to avoid antibiotic overuse.

Keywords:
GAS pharyngitisGroup A beta‐hemolytic Streptococcus rapid antigen‐detection test

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Area of Science:

  • Pediatric infectious diseases
  • Diagnostic test accuracy

Background:

  • Rapid antigen-detection tests (RADTs) are standard for diagnosing group A Streptococcus (GAS) pharyngitis.
  • Concerns exist regarding increased false positives in recently treated GAS patients, potentially leading to antibiotic overuse.

Purpose of the Study:

  • To investigate if RADTs exhibit an elevated false positive rate in children recently treated for GAS pharyngitis.

Main Methods:

  • A prospective study compared 300 children recently treated for GAS pharyngitis (study group) with 306 untreated children (control group).
  • Both RADT and throat cultures were performed on all participants presenting with acute pharyngitis symptoms.
  • False positive and false negative rates were calculated and compared between the groups.

Main Results:

  • The study group showed a significantly higher false positive rate of 11.5% compared to 0% in the control group.
  • False positives were more prevalent in younger children within the study group.

Conclusions:

  • RADTs are generally reliable but can lead to overtreatment in children recently treated for GAS.
  • For children treated for GAS within 28 days, throat cultures are essential for confirming active infection.
  • Positive RADT results should guide treatment decisions primarily in children not recently treated for GAS.