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=== Table 1===
=== Table 1<ref name="pmid: 21281502">{{cite journal| author=Regoli M, Chiappini E, Bonsignori F, Galli L, de Martino M| title=Update on the management of acute pharyngitis in children. | journal=Ital J Pediatr | year= 2011 | volume= 37 | issue=  | pages= 10 | pmid=: 21281502 | doi=10.1186/1824-7288-37-10 | pmc=3042010 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21281502  }}</ref>===
Clinical signs and symptoms of GABSH pharingitis , their sensitivity and specificity [5]
Clinical signs and symptoms of GABSH pharingitis , their sensitivity and specificity [5]
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Revision as of 05:38, 17 August 2020


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Sore throat resident survival guide (pediatrics) Microchapters
Overview
Causes
FIRE
Diagnosis
Treatment
Do's
Don'ts

Overview

This section provides a short and straight to the point overview of the disease or symptom. The first sentence of the overview must contain the name of the disease.

Causes

Life Threatening Causes

Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Bacteria

  • Streptococcus( group A beta-haemolytic )
  • Haemophilus influenzae
  • Moraxella catarrhalis

viruses[1]

  • Rhinovirus.
  • coronavirus.
  • respiratory syncytial virus.
  • metapneumovirus.
  • Epstein–Barr virus.

chemical irritation[1]

  • nasogastric tubes.
  • smoke.

FIRE: Focused Initial Rapid Evaluation


Table 1[2]

Clinical signs and symptoms of GABSH pharingitis , their sensitivity and specificity [5]

Symptoms and Clinical Findings Sensitivity (%) Specificity (%)
Absence of cough 51-79 36-68
Anterior cervical nodes swollen or enlarged 55-82 34-73
Headache 48 50-80
Myalgia 49 60
Palatine petechiae 7 95
Pharyngeal exudates 26 88
Fever >38°C 22-58 52-92
Tonsillar exudate 36 85


Table 2

Clinical Score for GABSH pharyngitis.

Reference Clinical signs and symptoms Sensibility (%) Specificity (%)
[37] Recent exposure to GABHS, pharyngeal exudate, enlarged or tender cervical nodes, fever 55 74
[38] Season, age, white cells count, fever, absence of cough, enlarged cervical nodes, tonsillar exudate or swelling 68 85
[39] Swollen and tender anterior cervical nodes, tonsillar exudate 84 40
[40] Fever, cervical nodes enlargement, tonsillar exudate or swelling or hypertrophy, Absence of cough 63 67
[41] Season, age, fever, enlarged cervical nodes, tonsillar exudate or swelling or hypertrophy, absence of cough or rhinitis or conjunctivitis 22 93
[42] Tonsillar hypertrophy, enlarged cervical nodes, absence of rhinitis, scarlet fever rash 18 97


Table 3


Table 3

Centor Score [24].

Clinical criteria Points
Absence of cough 1
Swollen and tender anterior cervical nodes 1
Temperature > 38°C 1
Tonsillar exudate or swelling 1
Age 3 to 14 years 1
Age 15 to 44 years 0
Age 45 years and older -1


Complete Diagnostic Approach"portal.nnpbc.com" (PDF).

• Rapid strep test (if available)

• Throat swab for culture and sensitivity

• If the child is greater than 2 years old, culture the throat before treatment or do rapid Strep antigen test (if available); if negative, do throat culture.

• Monospot if suspect vira

Treatment

penicillin is first choice treatment, since GABHS remains universally susceptible to penicillin. Although penicillin V is the drug of choice, ampicillin or amoxicillin are good taste, represent a suitable option in children.


Table 4

Therapeutic options for GABHS pharyngitis recommended by American Hearth Association and American Academy of Pediatrics AAP [13,4].

Drug Dose Duration
Penicillins
Penicillin V (oral) • Children <27 kg: 400 000 U (250 mg) 2 to 3 times daily ;

• Children >27 kg, adolescents, and adults: 800 000 (500 mg) 2 to 3 times daily

10 days
Amoxicillin (oral) 50 mg/kg once daily (maximum 1 g) 10 days
Benzathin Penicillin G (intramuscular) • Children <27 kg: 600 000 U (375 mg);

• Children >27 kg, adolescents, and adults: 1 200 000 U (750 mg)

Once
For individuals allergic to penicillin
Narrow-spectrum cephalosporin (cephalexin, cefadroxil) (oral)* Variable 10 days
Clindamycin (oral) 20 mg/kg per day divided in 3 doses (maximum 1.8 g/d) 10 days
Azithromycin (oral) 12 mg/kg once daily (maximum 500 mg) 5 days
Clarithromycin (oral) 15 mg/kg per day divided BID (maximum 250 mg BID) 10 days

* Patients with immediate or type I hypersensitivity to penicillin should not be treated with a cephalosporin [4].

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Do's

  • The content in this section is in bullet points.

Don'ts

  • The content in this section is in bullet points.

References

  1. ↑ 1.0 1.1
  2. ↑ Regoli M, Chiappini E, Bonsignori F, Galli L, de Martino M (2011). "Update on the management of acute pharyngitis in children". Ital J Pediatr. 37: 10. doi:10.1186/1824-7288-37-10. PMC 3042010. PMID 21281502 : 21281502 Check |pmid= value (help).


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