Evaluation of Symptoms and Findings in Children with Tonsillopharyngitis Reflecting The Presence of Beta Hemolytic Streptococcal Infection

Year 2019, , 226 - 231, 28.06.2019

Şamil Hızlı , Filiz Meryem Altay

https://doi.org/10.17098/amj.575478

Cited By: 1

Abstract

Objectives:
The administration of
antibiotic is used to be indicated, based on the incidence of nonsuppurative
complications (post-streptococcal glomerulonephritis and acute rheumatic fever)
after streptococcal pharyngitis and also suppurative complications. History and
physical examination findings distinguishing between GABHS and non-GABHS
pharyngitis is valuable in order to start antibiotics at right time and at
right dose.

Material
and Methods: A prospective
study was performed on a cohort of children with acute tonsillopharyngitis (n =
300).  The smymptoms at application and
signs in physical examination were recorded and analyzed in relation to throat
swab culture results at inclusion. Mean age was 67.70 ± 40 months (14-168 mo),  % 45.33 (n=136) were female, the others were
male. Age, sore throat, fever, headache, swallowing difficulty, myalgia, skin
eruptions, abdominal pain, nausea, vomiting, family history, the number of
people in house, the duration of symptoms of disease findings before admission
asked and tonsillar hypertrophy, presence of cryptitis and cervical lymph node sensitivity
recorded. Throat swab culture had taken from all of the patients.

Results: Throat swab culture results were as follows;
20%(n=60) beta hemolytic streptococci(BHS) and 83.33% of them(n=50) were Group
A. The mean age of BHS group (85.81± 39 mo) was higher than non BHS group (63.13
± 39 mo) (p<0.001).  Headache(p<0.001),
myalgia(p<0,001), difficulty in swallowing(p=0.040), skin eruptions(p=0.011)
were significantly related with BHS infection. The other findings were not
statistically significant.

Conclusion: The findings of this study would be usefull to
determine the decision of antibiotic treatment in clinical conditions where the
throat culture is not available in the clinic. 

Keywords

Child, Tonsillopharnygitis, Beta Hemolytic Streptococci, Symptom, Sign, Throat culture

Akut Tonsillofarenjitli Çocuklarda Beta Hemolitik Streptokok Varlığını Gösteren Belirti ve Bulguların Değerlendirilmesi

Abstract

Amaç: Streptokoksik
tonsillofarenjitte erken ve uygun antibiyotik tedavisi semptomları azaltıp
bulaşıcılık süresinin kısaltılmasında, akut glomerülonefrit ve akut romatizmal
ateş gibi poststreptokokkal komplikasyonların önlenmesinde önemlidir. Öykü ve
fizik muayene bulgularından etiyolojiye ışık tutanların belirlenmesi tedavinin
erken ve uygun antibiyotikle başlanmasını sağlayabilir.

Materyal ve Metot: Bu
çalışmada üst solunum yolu enfeksiyonu belirtileri ile başvuran ve klinik
olarak akut tonsillofarenjit tanısı alan 300 vaka prospektif olarak
değerlendirildi. Hastaların yaş ortalaması 67,70 ± 40 ay (14-168 ay) olup
136’sı (% 45,33) kız; 164’ü (% 54,66) erkekti. Hastalar yaş, akut boğaz ağrısı,
ateş, başağrısı, yutma güçlüğü, myalji, döküntü, karın ağrısı, bulantı, kusma,
aile öyküsü, evdeki fert sayısı, başvuru öncesi hastalık süresi açısından
sorgulandı, fizik muayenedeki tonsil hipertrofisi, kript, servikal lenf bezi
hassasiyeti kaydedildi. Tüm hastalardan boğaz kültürü alındı.

Bulgular: Boğaz kültürü
sonuçlarına göre 60(%20) hastada beta hemolitik streptokok(BHS) izole edilirken,
bunlardan 50(%83,33)’si A grubu olarak gruplandı. BHS izole edilen ve BHS izole
edilmeyen vakalar karşılaştırıldığında yaş ortalamaları BHS grubunda 85,81±39,
BHS üremeyen grupta 63,13±39 ay(p<0,001) bulundu. Öyküde
başağrısı(p<0,001), myalji(p<0,001), yutma güçlüğü (p=0,040) ve döküntü(p=0,011)
varlığı ile BHS izolasyonu arasında istatistiksel olarak anlamlı bir ilişki
bulundu. Diğer veriler anlamlı değildi. 

Sonuç: Hastaların
bakteriyolojik olarak değerlendirilmesinin mümkün olmadığı durumlarda öykü ve
klinik bulgulardan spesifik olanların değerlendirilmesi çocuk hastalarda
gelişene tonsillofarenjitin ampirik tedavisinde yol gösterici olacaktır.

Keywords

Çocuk, Tonsillofarenjit, Beta Hemolitik Streptokok, Belirti, Bulgu, Boğaz kültürü

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