Mehtap BİNGÜL, Duygu SÖMEN BAYOĞLU, Tamay GÜRBÜZ, Pınar ALAGÖZ, Sebahat AKSARAY, Çağatay NUHOĞLU

Çocuklarda Streptokoksik Tonsillofarenjit Tanısında Hızlı Antijen Testi ile McIsaac / Modifiye Centor Skorlamalarının Etkinliği

Amaç: Bu çalışmada çocuklarda grup A streptokok (GAS) infeksiyonlarını saptamada hızlı antijen testi, klinik bulgular ile McIsaac / modifiye Centor klinik skorlamalarının etkinliğinin saptanması amaçlandı. Materyal ve Metot: Çalışmada akut tonsillofarenjitle başvuran 3-14 yaş arası olgular sosyodemografik ve semptomlar yönünden sorgulandı. Klinik bulguları ve McIsaac / modifiye Centor skorlamaları kaydedildi. Olguların tümüne hızlı streptokok antijen testi uygulandı ve boğaz kültürü çalışıldı. Bulgular: Olguların % 11 inde GAS kültürde üredi. Altı yaş ve üzeri çocuklarda kültür pozitifliği riski 4.8 kat daha fazla saptandı. Kas ağrısı ve tonsiller ödem ile kültür pozitifliği arasında istatiksel anlamlı ilişki mevcuttu Hızlı antijen testi streptokok tonsillofarenjiti tanısında %75 duyarlılığa, %100 özgüllüğe sahip olarak bulundu. McIsaac / modifiye Centor skoru 4-5 olan çocuklarda hızlı antijen testi streptokok tonsillofarenjiti tanısında %80 duyarlılık, %100 özgüllük gösterdi. Sonuç: Akut tonsillofarenjitte gereksiz antibiyotik kullanımı önemli bir sorundur. Bu nedenle GAS infeksiyonunu düşündüren her olguda boğaz kültürünün istenmesi ve ona göre hareket edilmesi ideal olandır. Ancak kültürün yapılamadığı durumlarda tanı ve tedaviyi yönlendirmede hızlı strep testi ve McIsaac / modifiye Centor skorlaması etkilidir.

Anahtar Kelimeler:

Çocuk, Bakteriyel antijenler, streptokokal enfeksiyonlar

Efficacy of Rapid Antigen Test and McIsaac / Modified Centor Scores for Diagnosis of Streptococcal Tonsillopharyngitis in Children

Objective: We aimed to determine the efficacy of rapid antigen tests, clinical signs, and McIsaac / modified Centor clinical scoring systems in the diagnosis of Group A streptococcus (GAS) at children. Materials and Methods: Subjects aged 3-14 years who presented with acute tonsillopharyngitis were questioned about their sociodemographic properties and symptoms. Their clinical signs and McIsaac / modified Centor scores were recorded. They underwent a rapid streptococcal antigen test and throat culture sampling. Results: GAS proliferated in culture %11 of cases. The risk of culture positivity was 4.8 times greater in children aged 6 years or older. There was a significant correlation between culture positivity and muscle pain, tonsillar edema. Rapid strep test had a sensitivity of 75% and a specifity of 100% for the diagnosis of streptococcal tonsillopharyngitis. Rapid strep test showed a sensitivity of 80% and a specifity of 100% in children with a McIsaac / modified Centor score of 4-5. Conclusions: Unnecessary antibiotic use for tonsillopharyngitis is an important problem. Therefore, it is ideal to order throat culture and act accordingly in every case suggesting GAS infection. However, when culture is not possible, rapid strep testing and McIsaac / modified Centor scoring are effective in guiding diagnosis and treatment.

Keywords:

Child , Bacterial antigens, streptococcal infections,

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