Abstract
|
Performance of Clinical Features, Acute Phase Reactants and Group A Streptococcus Rapid Test in Evaluation of the Etiologic Agents for Tonsillopharyngitis in Children
by Bahri Elmas, Mehmet Köroğlu, Hüseyin A. Terzi, Ferhat G. Aslan, Engin Menekşe, Mustafa Kösecik, Mustafa Altindiş
|
|
|
Background: It is important to determine the causative agent of tonsillopharyngitis in children, whether group A beta-hemolytic streptococcus (GABHS) or another agent. In this study, we investigated epidemiological data and clinical symptoms and also evaluated the performance of group A streptococcus rapid test (GASRT) and acute- phase reactant tests in distinguishing viral and bacterial agents by performing assays for GABHS and for Epstein- Barr virus (EBV), herpes simplex virus type 1 (HSV-1), adenovirus, and enterovirus, from samples obtained from children with tonsillopharyngitis.
Methods: One hundred fifty pediatric patients were evaluated for complaints of body fever, sore throat, headache, cough, and abdominal pain. Identification of GAS isolates was performed using culture, a rapid test for GAS de- tection, and a L-pyrrolidonyl arylamidase (PYR) test, as well as a latex agglutination test and the Vitek 2 automat- ed system when needed. The complete blood count (CBC), neutrophil/lymphocyte ratio (NLR), anti-streptolysin O (ASO), sedimentation, and high-sensitivity C-reactive protein (hs-CRP) were quantified. Molecular analyses were performed for EBV, adenovirus, enterovirus, and HSV-1 detection using the Anatolia Montania 4896 RT PCR platform.
Results: Throat cultures were positive for GABHS in 11 (7.3%) children. The absence of coughing and the pres- ence of painful cervical LAP were significantly higher in the GABHS-positive group. GASRT was positive in 14 (9.2%) children; 10 (90%) of the 11 GABHS culture-positive cases were also positive for GASRT. In the GABHS- positive group, there was no difference in sedimentation or ASO values compared with GABHS-negative group. When the viral agent-positive group was compared with the group where no agent was found, WBC, NLR, and CRP were significantly higher, and PLT was significantly lower.
Conclusions: Causative agent of acute tonsillopharyngytis in children is usually a virus. EBV was the most com- mon viral agent in tonsillopharyngitis. The absence of coughing and the presence of painful cervical lymphade- nopathy can be important indicators in the diagnosis of GABHS positivity. GASRT is a highly reliable assay. WBC, NLR, and CRP are higher in GABHS-positive patients.
DOI: 10.7754/Clin.Lab.2017.170124
|
