Journal of the Korean Pediatric Society 2001;44(7):732-741.
Published online July 15, 2001.
Clinical Manifestations of Group A β-Hemolytic Streptococcal Pharyngits and Usefulness of Rapid Antigen Test
Youn Jeong Shin1, Seong Hee Jang1, Eun Sil Dong1, Young Min Ahn1, Myung Suk Ku2
1Department of Pediatrics, Kangnam General Hospital Public Co., Seoul, Korea
2Department of Clinical Pathology, Kangnam General Hospital Public Co., Seoul, Korea
A군 베타용혈성 연쇄구균에 의한 인두염의 임상양상 및 신속항원검사법의 유용성
신윤정1, 장성희1, 동은실1, 안영민1, 구명숙2
1지방공사 강남병원 소아과
2지방공사 강남병원 임상병리과
Abstract
Purpose
: Accurate diagnosis of group A streptococcal(GAS) pharyngitis and appropriate antimicrobial therapy are important, particularly to prevent nonsuppurative sequelae and to reduce the improper use of antibiotics. Because the clinical presentation of pharyngitis does not reliably predict the etiologic agent, when GAS infection is suspected, diagnosis should be based on the result of a throat swab culture or antigen-detection test with culture back-up.
Methods
: We reviewed retrospectively the medical records of children diagnosed as GAS pharyngitis by throat swab culture from Jan. 1995 to Jul. 2000. Since Nov. 1998, specimens were also tested with the Abbott's Testpack+plus Strep A Kit.
Results
: 121 patients were confirmed as GAS pharyngitis by throat culture. GAS pharyngitis predominantly occurred from 3 to 7 years of age with the peak incidence at 4 and 5 years of age. The disease was more frequent in late fall, winter and spring. Clinical manifestations were as follows; fever(89.9%), abnormal pharynx(94.3%), of which exudate in 33.6%, sore throat(85.3%), headache(78.1%), cervical lymphadenopathy(67.5%), abdominal pain(64.3%), and nausea or vomiting (55.0%). The sensitivity and specificity of rapid antigen test compared to throat culture were 96.4% and 95%, respectively.
Conclusion
: GAS pharyngitis occurred every year, and more frequently in late fall, winter and spring. It occurred with the greatest frequency in preschool children. The rapid antigen test can be a basis for clinicians to decide how to treat their patients before the culture results are proven, and can be helpful to judicious use of antibiotics as well.
Key Words: GAS pharyngitis, Rapid antigen test


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