A Scoring System for Management of Acute Pharyngo-tonsillitis in Adults

Overview

Journal Auris Nasus Larynx

Specialty Otorhinolaryngology

Date 2008 Sep 9

PMID 18774249

Citations 2

Authors

Masaki Suzumoto

Muneki Hotomi

Dewan S Billal

Keiji Fujihara

Yasuaki Harabuchi

Noboru Yamanaka

Affiliations

Soon will be listed here.

Abstract

Objectives: The aim of this study was to develop and evaluate a scoring system for the management of acute pharyngo-tonsillitis.

Methods: We conducted a prospective study between May 2004 and June 2005. Patients with acute pharyngo-tonsillitis were evaluated for causative pathogens and were assessed clinical symptoms and pharyngo-tonsillar finding by a clinical scoring system.

Results: A total 214 adult patients were enrolled in this study. Streptococcus pyogenes were identified at 13.6%. Thirty-one viruses were also identified by PCR. They were adenovirus (4.8%), influenza virus (1.0%), RS virus (6.3%), and human metapneumovirus (2.9%). Numbers of total white blood cells and levels of C-reactive protein showed a significant positive correlation with clinical scores (p<0.001) and were also higher in cases with S. pyogenes. The clinical scores rapidly improved after the antimicrobial treatments in moderate cases and severe cases.

Conclusion: The current study strongly suggested that the clinical scoring system reflected disease severity well and would be very useful for evaluating clinical course and decision making for the antimicrobial treatment of acute pharyngo-tonisllitis.

Citing Articles

Azithromycin in the Management of Upper Respiratory Tract Infections (URTIs): Indian Real-Life Experience.

Dominic M, Srivastava R, Shah K, Naik S, Rout K, Ray B Infect Drug Resist. 2025; 18:523-531.

PMID: 39898351 PMC: 11784350. DOI: 10.2147/IDR.S488479.

The Effects of a Dietary Supplement (PediaFlù) Plus Standard of Care in Children With Acute Tonsillopharyngitis/Rhinopharyngitis: Protocol for a Randomized Controlled Trial.

Cardinale F, Barattini D, Sbrocca F, Centi A, Giuntini G, Bordea M JMIR Res Protoc. 2024; 13:e53703.

PMID: 38819917 PMC: 11179036. DOI: 10.2196/53703.

Clinical Screening Tools to Diagnose Group A Streptococcal Pharyngotonsillitis in Primary Care Clinics to Improve Prescribing Habits.

Muthanna A, Salim H, Hamat R, Shamsuddin N, Zakariah S Malays J Med Sci. 2019; 25(6):6-21.

PMID: 30914875 PMC: 6422577. DOI: 10.21315/mjms2018.25.6.2.

References

Bisno A, Gerber M, Gwaltney Jr J, Kaplan E, Schwartz R . Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Infectious Diseases Society of America. Clin Infect Dis. 2002; 35(2):113-25. DOI: 10.1086/340949. View

Poses R, Cebul R, Collins M, Fager S . The accuracy of experienced physicians' probability estimates for patients with sore throats. Implications for decision making. JAMA. 1985; 254(7):925-9. View

Ordas J, Boga J, Alvarez-Arguelles M, Villa L, Rodriguez-Dehli C, de Ona M . Role of metapneumovirus in viral respiratory infections in young children. J Clin Microbiol. 2006; 44(8):2739-42. PMC: 1594650. DOI: 10.1128/JCM.00164-06. View

De Meyere M, Mervielde Y, Verschraegen G, Bogaert M . Effect of penicillin on the clinical course of streptococcal pharyngitis in general practice. Eur J Clin Pharmacol. 1992; 43(6):581-5. DOI: 10.1007/BF02284954. View

Bourbeau P . Role of the microbiology laboratory in diagnosis and management of pharyngitis. J Clin Microbiol. 2003; 41(8):3467-72. PMC: 179871. DOI: 10.1128/JCM.41.8.3467-3472.2003. View

Little P, Williamson I . Sore throat management in general practice. Fam Pract. 1996; 13(3):317-21. DOI: 10.1093/fampra/13.3.317. View

Wannamaker L . Perplexity and precision in the diagnosis of streptococcal pharyngitis. Am J Dis Child. 1972; 124(3):352-8. DOI: 10.1001/archpedi.1972.02110150050009. View

Linder J, Stafford R . Antibiotic treatment of adults with sore throat by community primary care physicians: a national survey, 1989-1999. JAMA. 2001; 286(10):1181-6. DOI: 10.1001/jama.286.10.1181. View

Kellogg J . Suitability of throat culture procedures for detection of group A streptococci and as reference standards for evaluation of streptococcal antigen detection kits. J Clin Microbiol. 1990; 28(2):165-9. PMC: 269569. DOI: 10.1128/jcm.28.2.165-169.1990. View

10.

Dagnelie C, Van der Graaf Y, de Melker R . Do patients with sore throat benefit from penicillin? A randomized double-blind placebo-controlled clinical trial with penicillin V in general practice. Br J Gen Pract. 1996; 46(411):589-93. PMC: 1239783. View

11.

Singh S, Dolan J, Centor R . Optimal management of adults with pharyngitis--a multi-criteria decision analysis. BMC Med Inform Decis Mak. 2006; 6:14. PMC: 1431519. DOI: 10.1186/1472-6947-6-14. View

12.

Gunnarsson R, Holm S, Soderstrom M . The prevalence of beta-haemolytic streptococci in throat specimens from healthy children and adults. Implications for the clinical value of throat cultures. Scand J Prim Health Care. 1997; 15(3):149-55. DOI: 10.3109/02813439709018506. View

13.

Huovinen P, Lahtonen R, Ziegler T, Meurman O, Hakkarainen K, Miettinen A . Pharyngitis in adults: the presence and coexistence of viruses and bacterial organisms. Ann Intern Med. 1989; 110(8):612-6. DOI: 10.7326/0003-4819-110-8-612. View

14.

BREESE B . A simple scorecard for the tentative diagnosis of streptococcal pharyngitis. Am J Dis Child. 1977; 131(5):514-7. DOI: 10.1001/archpedi.1977.02120180028003. View

15.

McIsaac W, White D, Tannenbaum D, Low D . A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ. 1998; 158(1):75-83. PMC: 1228750. View

16.

Webb K, Needham C, Kurtz S . Use of a high-sensitivity rapid strep test without culture confirmation of negative results: 2 years' experience. J Fam Pract. 2000; 49(1):34-8. View

17.

Kellogg J, Manzella J . Detection of group A streptococci in the laboratory or physician's office. Culture vs antibody methods. JAMA. 1986; 255(19):2638-42. View

18.

Centor R, Witherspoon J, Dalton H, Brody C, Link K . The diagnosis of strep throat in adults in the emergency room. Med Decis Making. 1981; 1(3):239-46. DOI: 10.1177/0272989X8100100304. View

19.

Little P, Gould C, Williamson I, Warner G, Gantley M, Kinmonth A . Reattendance and complications in a randomised trial of prescribing strategies for sore throat: the medicalising effect of prescribing antibiotics. BMJ. 1997; 315(7104):350-2. PMC: 2127265. DOI: 10.1136/bmj.315.7104.350. View

20.

BISNO A . Acute pharyngitis. N Engl J Med. 2001; 344(3):205-11. DOI: 10.1056/NEJM200101183440308. View