Sore throat resident survival guide (pediatrics): Difference between revisions
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===Common Causes=== | ===Common Causes=== | ||
=== [[Common cause 1|Bacteria]] | === [[Common cause 1|Bacteria]]=== | ||
* ''Streptococcus( group A beta-haemolytic )'' | * ''Streptococcus( group A beta-haemolytic )'' | ||
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==FIRE: Focused Initial Rapid Evaluation== | ==FIRE: Focused Initial Rapid Evaluation== | ||
<br /> | |||
=== Table 1 === | |||
Clinical signs and symptoms of GABSH pharingitis , their sensitivity and specificity [5] | |||
{| class="wikitable" | |||
! colspan="1" rowspan="1" |Symptoms and Clinical Findings | |||
! colspan="1" rowspan="1" |Sensitivity (%) | |||
! colspan="1" rowspan="1" |Specificity (%) | |||
|- | |||
| colspan="1" rowspan="1" |'''Absence of cough''' | |||
| colspan="1" rowspan="1" |51-79 | |||
| colspan="1" rowspan="1" |36-68 | |||
|- | |||
| colspan="3" rowspan="1" | | |||
---- | |||
|- | |||
| colspan="1" rowspan="1" |'''Anterior cervical nodes swollen or enlarged''' | |||
| colspan="1" rowspan="1" |55-82 | |||
| colspan="1" rowspan="1" |34-73 | |||
|- | |||
| colspan="3" rowspan="1" | | |||
---- | |||
|- | |||
| colspan="1" rowspan="1" |'''Headache''' | |||
| colspan="1" rowspan="1" |48 | |||
| colspan="1" rowspan="1" |50-80 | |||
|- | |||
| colspan="3" rowspan="1" | | |||
---- | |||
|- | |||
| colspan="1" rowspan="1" |'''Myalgia''' | |||
| colspan="1" rowspan="1" |49 | |||
| colspan="1" rowspan="1" |60 | |||
|- | |||
| colspan="3" rowspan="1" | | |||
---- | |||
|- | |||
| colspan="1" rowspan="1" |'''Palatine petechiae''' | |||
| colspan="1" rowspan="1" |7 | |||
| colspan="1" rowspan="1" |95 | |||
|- | |||
| colspan="3" rowspan="1" | | |||
---- | |||
|- | |||
| colspan="1" rowspan="1" |'''Pharyngeal exudates''' | |||
| colspan="1" rowspan="1" |26 | |||
| colspan="1" rowspan="1" |88 | |||
|- | |||
| colspan="3" rowspan="1" | | |||
---- | |||
|- | |||
| colspan="1" rowspan="1" |'''Fever >38°C''' | |||
| colspan="1" rowspan="1" |22-58 | |||
| colspan="1" rowspan="1" |52-92 | |||
|- | |||
| colspan="3" rowspan="1" | | |||
---- | |||
|- | |||
| colspan="1" rowspan="1" |'''Tonsillar exudate''' | |||
| colspan="1" rowspan="1" |36 | |||
| colspan="1" rowspan="1" |85 | |||
|} | |||
=== Table 2 === | |||
Clinical Score for GABSH pharyngitis. | |||
{| class="wikitable" | |||
! colspan="1" rowspan="1" |Reference | |||
! colspan="1" rowspan="1" |Clinical signs and symptoms | |||
! colspan="1" rowspan="1" |Sensibility (%) | |||
! colspan="1" rowspan="1" |Specificity (%) | |||
|- | |||
| colspan="1" rowspan="1" |[37] | |||
| colspan="1" rowspan="1" |Recent exposure to GABHS, pharyngeal exudate, enlarged or tender cervical nodes, fever | |||
| colspan="1" rowspan="1" |55 | |||
| colspan="1" rowspan="1" |74 | |||
|- | |||
| colspan="4" rowspan="1" | | |||
---- | |||
|- | |||
| colspan="1" rowspan="1" |[38] | |||
| colspan="1" rowspan="1" |Season, age, white cells count, fever, absence of cough, enlarged cervical nodes, tonsillar exudate or swelling | |||
| colspan="1" rowspan="1" |68 | |||
| colspan="1" rowspan="1" |85 | |||
|- | |||
| colspan="4" rowspan="1" | | |||
---- | |||
|- | |||
| colspan="1" rowspan="1" |[39] | |||
| colspan="1" rowspan="1" |Swollen and tender anterior cervical nodes, tonsillar exudate | |||
| colspan="1" rowspan="1" |84 | |||
| colspan="1" rowspan="1" |40 | |||
|- | |||
| colspan="4" rowspan="1" | | |||
---- | |||
|- | |||
| colspan="1" rowspan="1" |[40] | |||
| colspan="1" rowspan="1" |Fever, cervical nodes enlargement, tonsillar exudate or swelling or hypertrophy, Absence of cough | |||
| colspan="1" rowspan="1" |63 | |||
| colspan="1" rowspan="1" |67 | |||
|- | |||
| colspan="4" rowspan="1" | | |||
---- | |||
|- | |||
| colspan="1" rowspan="1" |[41] | |||
| colspan="1" rowspan="1" |Season, age, fever, enlarged cervical nodes, tonsillar exudate or swelling or hypertrophy, absence of cough or rhinitis or conjunctivitis | |||
| colspan="1" rowspan="1" |22 | |||
| colspan="1" rowspan="1" |93 | |||
|- | |||
| colspan="4" rowspan="1" | | |||
---- | |||
|- | |||
| colspan="1" rowspan="1" |[42] | |||
| colspan="1" rowspan="1" |Tonsillar hypertrophy, enlarged cervical nodes, absence of rhinitis, scarlet fever rash | |||
| colspan="1" rowspan="1" |18 | |||
| colspan="1" rowspan="1" |97 | |||
|} | |||
==Complete Diagnostic Approach== | ==Complete Diagnostic Approach== | ||
Diagnostic Tests | |||
• Rapid strep test (if available) • Throat swab for culture and sensitivity • If the child is greater than 2 years old, culture the throat before treatment or do rapid Strep antigen test (if available); if negative, do throat culture. • Monospot if suspect vira | |||
==Treatment== | ==Treatment== | ||
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{{WikiDoc Help Menu}} | {{WikiDoc Help Menu}} | ||
{{WikiDoc Sources}} | {{WikiDoc Sources}} | ||
<references /> |
Revision as of 04:57, 17 August 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
Sore throat resident survival guide (pediatrics) Microchapters |
---|
Overview |
Causes |
FIRE |
Diagnosis |
Treatment |
Do's |
Don'ts |
Overview
This section provides a short and straight to the point overview of the disease or symptom. The first sentence of the overview must contain the name of the disease.
Causes
Life Threatening Causes
Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.
Common Causes
Bacteria
- Streptococcus( group A beta-haemolytic )
- Haemophilus influenzae
- Moraxella catarrhalis
viruses[1]
- Rhinovirus.
- coronavirus.
- respiratory syncytial virus.
- metapneumovirus.
- Epstein–Barr virus.
chemical irritation[1]
- nasogastric tubes.
- smoke.
FIRE: Focused Initial Rapid Evaluation
Table 1
Clinical signs and symptoms of GABSH pharingitis , their sensitivity and specificity [5]
Symptoms and Clinical Findings | Sensitivity (%) | Specificity (%) |
---|---|---|
Absence of cough | 51-79 | 36-68 |
| ||
Anterior cervical nodes swollen or enlarged | 55-82 | 34-73 |
| ||
Headache | 48 | 50-80 |
| ||
Myalgia | 49 | 60 |
| ||
Palatine petechiae | 7 | 95 |
| ||
Pharyngeal exudates | 26 | 88 |
| ||
Fever >38°C | 22-58 | 52-92 |
| ||
Tonsillar exudate | 36 | 85 |
Table 2
Clinical Score for GABSH pharyngitis.
Reference | Clinical signs and symptoms | Sensibility (%) | Specificity (%) |
---|---|---|---|
[37] | Recent exposure to GABHS, pharyngeal exudate, enlarged or tender cervical nodes, fever | 55 | 74 |
| |||
[38] | Season, age, white cells count, fever, absence of cough, enlarged cervical nodes, tonsillar exudate or swelling | 68 | 85 |
| |||
[39] | Swollen and tender anterior cervical nodes, tonsillar exudate | 84 | 40 |
| |||
[40] | Fever, cervical nodes enlargement, tonsillar exudate or swelling or hypertrophy, Absence of cough | 63 | 67 |
| |||
[41] | Season, age, fever, enlarged cervical nodes, tonsillar exudate or swelling or hypertrophy, absence of cough or rhinitis or conjunctivitis | 22 | 93 |
| |||
[42] | Tonsillar hypertrophy, enlarged cervical nodes, absence of rhinitis, scarlet fever rash | 18 | 97 |
Complete Diagnostic Approach
Diagnostic Tests
• Rapid strep test (if available) • Throat swab for culture and sensitivity • If the child is greater than 2 years old, culture the throat before treatment or do rapid Strep antigen test (if available); if negative, do throat culture. • Monospot if suspect vira
Treatment
Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.
Do's
- The content in this section is in bullet points.
Don'ts
- The content in this section is in bullet points.