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A streptococcal score card revisited

E R Wald1, M D Green, B Schwartz

  • 1University of Pittsburgh School of Medicine, Pennsylvania, USA.

Pediatric Emergency Care
|May 16, 1998
PubMed
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A simple scoring system effectively predicts positive throat cultures for group A streptococci (GAS) in children. Scores of 5 or 6 indicate a high likelihood of GAS infection, aiding clinical decisions.

Area of Science:

  • Pediatric infectious diseases
  • Clinical diagnostics
  • Microbiology

Background:

  • Group A streptococci (GAS) pharyngitis is common in children.
  • Accurate diagnosis is crucial to prevent complications.
  • Predictive scoring systems can aid in identifying GAS infections.

Purpose of the Study:

  • To assess the predictive value of a simple scoring system for positive GAS throat cultures.
  • To determine the utility of the score in a pediatric emergency department and walk-in clinic setting.

Main Methods:

  • A prospective descriptive study involving 365 children aged 2-16 with acute sore throat and fever.
  • A 6-point streptococcal score was assigned based on age, season, temperature, adenopathy, pharyngeal findings, and absence of viral symptoms.

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  • Throat cultures were performed to detect GAS.

    • Main Results:

    • A score of 5 or 6 predicted a positive GAS culture in 59% and 75% of children, respectively.
    • In children with acute pharyngitis, specific criteria (age 5-15, fever, no URI symptoms) predicted a positive GAS culture in 72%.

    Conclusions:

    • The developed streptococcal score is a useful tool for predicting positive GAS throat cultures.
    • This scoring system can help guide the need for throat cultures in children presenting with sore throat.