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Accuracy and precision of the signs and symptoms of streptococcal pharyngitis in children: A systematic review

Shaikh, N and Swaminathan, N and Hooper, EG (2012) Accuracy and precision of the signs and symptoms of streptococcal pharyngitis in children: A systematic review. Journal of Pediatrics, 160 (3). ISSN 0022-3476

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Objective: To conduct a systematic review to determine whether clinical findings can be used to rule in or to rule out streptococcal pharyngitis in children. Study design: Two authors independently searched MEDLINE and EMBASE. We included articles if they contained data on the accuracy of symptoms or signs of streptococcal pharyngitis, individually or combined into prediction rules, in children 3-18 years of age. Results: Thirty-eight articles with data on individual symptoms and signs and 15 articles with data on prediction rules met all inclusion criteria. In children with sore throat, the presence of a scarlatiniform rash (likelihood ratio [LR], 3.91; 95% CI, 2.00-7.62), palatal petechiae (LR, 2.69; CI, 1.92-3.77), pharyngeal exudates (LR, 1.85; CI, 1.58-2.16), vomiting (LR, 1.79; CI, 1.58-2.16), and tender cervical nodes (LR, 1.72; CI, 1.54-1.93) were moderately useful in identifying those with streptococcal pharyngitis. Nevertheless, no individual symptoms or signs were effective in ruling in or ruling out streptococcal pharyngitis. Conclusions: Symptoms and signs, either individually or combined into prediction rules, cannot be used to definitively diagnose or rule out streptococcal pharyngitis. © Copyright 2012 Mosby Inc. All rights reserved.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Shaikh, Nnas67@pitt.eduNAS67
Swaminathan, N
Hooper, EG
Date: 1 January 2012
Date Type: Publication
Journal or Publication Title: Journal of Pediatrics
Volume: 160
Number: 3
DOI or Unique Handle: 10.1016/j.jpeds.2011.09.011
Schools and Programs: School of Medicine > Pediatrics
Refereed: Yes
ISSN: 0022-3476
Related URLs:
MeSH Headings: Adolescent; Child; Child, Preschool; Decision Support Techniques; Humans; Pharyngitis--diagnosis; Pharyngitis--microbiology; Physical Examination; Sensitivity and Specificity; Streptococcal Infections--diagnosis; Streptococcus pyogenes
PubMed ID: 22048053
Date Deposited: 11 Sep 2012 21:33
Last Modified: 05 Feb 2019 11:55


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