Razi Journal of Medical Sciences
مجله علوم پزشکی رازی
RJMS
Medical Sciences
http://rjms.iums.ac.ir
39
journal39
2228-7043
2228-7051
en
jalali
1374
12
1
gregorian
1996
3
1
2
زمستان
online
1
fulltext
fa
فارنژیت استرپتوکوکی در کودکان ( بررسی 100 مورد)
STREPTOCOCCAL PHARYNGITIS IN CHILDREN: SURVEY OF 100 CASES
بیماریهای اطفال
Pediatric Disease
موردنگاري
case report
<p style="DIRECTION: rtl"> به منظور بررسی میزان فارنژیت استرپتوکوکی در گلودردهای کودکان و همچنین یافتن رابطه ای بین علائم بالینی و نتایج کشت گلو یک مطالعه به مدت یکسال و از تاریخ اول مهر 1371 لغایت 31 شهریور 1372 بطول انجامید. از مجموع <strong><i>A </i></strong>443 کودک با شکایت گلودرد 100 نفر ( 5/22 ) دارای کشت مثبت گلو از نظر استرپتوکوک بتاهمولی تیک گروه شدند. 53 دصد از بیماران پسر و 47 درصد دختر بودند. سن متوسط بیماران 3 + 8/8 سال بود. شایع ترین علائم بالینی به ترتیب عبارت بودند از : قرمزی گلو 99 درصد، شیوع ناگهانی 86 درصد، تب 84 درصد، اگزودای روی لوزه ها 69 درصد، حساسیت و دردناکی غدد لنفاوی قدامی گردن 30 درصد و عوامل گوارشی همراه 22 درصد. شیوع فصلی بیماری به ترتیب زیر بود : بهار 35 درصد ، زمستان 34 درصد ، پاییز 28 درصد و تابستان 3 درصد. 53 از بیماران دارای 5 علامت بودند. وجود 5 علامت گلودرد+تب+شروع ناگهانی+قرمزی گلو+اگزودا در غیاب علائم ویرال دارای حساسیت 57 درصد، اختصاصیت 98 درصد، ارزش پیش بینی کننده مثبت 89 درصد، ارزش پیش بینی کننده منفی 89 درصد و کارآئی 89 درصد می باشد. این مطالعه نشان داد که در صورت فقدان امکانات آزمایشگاهی با دقت به علائم بالینی می توان به تشخیص نسبتا صحیح ون دقیقی از فارنژیت استرپتوکوکی رسید. </p>
<div style="mso-element: frame mso-element-frame-width: 4.85in mso-element-frame-height: 477.6pt mso-element-wrap: auto mso-element-anchor-horizontal: margin mso-element-left: .05pt mso-element-top: .05pt"><tbody><tr><td style="BORDER-BOTTOM: #f0f0f0 BORDER-LEFT: #f0f0f0 PADDING-BOTTOM: 0in BACKGROUND-COLOR: transparent PADDING-LEFT: 0in PADDING-RIGHT: 0in BORDER-TOP: #f0f0f0 BORDER-RIGHT: #f0f0f0 PADDING-TOP: 0in" height="637" valign="top" align="left"><p style="TEXT-JUSTIFY: inter-ideograph TEXT-ALIGN: justify LINE-HEIGHT: 17.75pt TEXT-INDENT: 15.35pt MARGIN: 0.7pt 0in 0pt 5.75pt mso-element: frame mso-element-frame-width: 4.85in mso-element-frame-height: 477.6pt mso-element-wrap: auto mso-element-anchor-horizontal: margin mso-element-left: .05pt mso-element-top: .05pt mso-line-height-rule: exactly" class="Style"><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">This prospective study was designed to find the incidence of streptococcal pharyngitis in childhood sore throat and also to compare the clinical diagnosis of disease with the results of throat cultures. <p></p></span></i></p><p style="LINE-HEIGHT: 17.75pt MARGIN: 0.2pt 1.9pt 0pt 1.2pt mso-element: frame mso-element-frame-width: 4.85in mso-element-frame-height: 477.6pt mso-element-wrap: auto mso-element-anchor-horizontal: margin mso-element-left: .05pt mso-element-top: .05pt mso-line-height-rule: exactly" class="Style"><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">Children, </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">5 </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">to </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">15 </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">years of age with sore throat who were seen in pediatric out </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">- <i>patients department formed the subjects of this study. The duration of study was one year (October </i></span><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">1992 - </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">October </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">1993). </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">There were 443 children with sore throat. 100 patients </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">(22.5%) </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">had positive throat culture (group A Beta hemolytic streptococci) </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">. </span><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">53 </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">patients </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">(53%) </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">were male and </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt mso-font-width: 110%">47% </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">were female. The mean age of the group was </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt mso-font-width: 110%">8.8 </span><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 137%">± </span><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt mso-font-width: 110%">3 </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">years. Clinical findings in order of frequency were as follow: redness of pharynx </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">99% , </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">acute onset of symptoms </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">86% , </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">fever </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">84% </span><span style="FONT-SIZE: 3.5pt mso-font-width: 140%"><font face="Times New Roman">1 </font></span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">exudate on tonsils </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">69% , </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">enlargement and tenderness of anterior cervical lymph nodes 30% </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">, <i>and associated gastrointestinal symptoms </i></span><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">22% . </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">Seasonal prevalence of disease were as follow: spring </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">35%, </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">winter </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">34% , </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">autumn </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">28 % </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">and summer </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">3%. 53% </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">of this patients had </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">5 </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">clinical symptoms. 5 clinical findings such as sore throat </span></i><span style="FONT-FAMILY: "Arial","sans-serif""><font size="3">+ </font></span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">fever </span></i><span style="FONT-FAMILY: "Arial","sans-serif""><font size="3">+ </font></span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">acute onset of disease </span></i><i><span style="FONT-FAMILY: "Arial","sans-serif""><font size="3">+ </font></span></i><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">redness of pharynx </span></i><span style="FONT-FAMILY: "Arial","sans-serif""><font size="3">+ </font></span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">exudate on tonsils and absence of viral symptoms (cough, coryza, conjunctivitis, hoarseness) had </span></i><span style="FONT-SIZE: 11pt"><font face="Times New Roman">a </font></span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">sensitivity of </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">57% , </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">specititv of </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">98% </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 3.5pt mso-font-width: 92%">J </span></i><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">positive predictive value of </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">89% , </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">negative predictive value of </span></i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9pt mso-font-width: 110%">89% </span><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">and efficiency of 89%. <p></p></span></i></p><p style="TEXT-JUSTIFY: inter-ideograph TEXT-ALIGN: justify LINE-HEIGHT: 17.75pt TEXT-INDENT: 15.6pt MARGIN: 0.45pt 6pt 0pt 0.2pt mso-element: frame mso-element-frame-width: 4.85in mso-element-frame-height: 477.6pt mso-element-wrap: auto mso-element-anchor-horizontal: margin mso-element-left: .05pt mso-element-top: .05pt mso-line-height-rule: exactly" class="Style"><i><span style="FONT-FAMILY: "Arial","sans-serif" FONT-SIZE: 9.5pt">This study showed that in the absence of laboratory facilities careful clinical findings can be helpful for reaching accurate diagnosis of streptococcal pharyngitis. <p></p></span></i></p></td></tr></tbody></table></div>
1- فارنژیت استرپتوکوکی 2- کشت گلو 3- گلودرد
1) Streptococcal pharyngitis 2) Throat culture 3) Sore throat
235
242
http://rjms.iums.ac.ir/browse.php?a_code=A-10-1-1204&slc_lang=fa&sid=1
S.
Roodpeyma
شهلا
رودپیما
3900319475328460021048
3900319475328460021048
Yes
H.A.
Babaei
حسین
بابائی
3900319475328460021049
3900319475328460021049
No
N.
Vallaei
ناصر
ولائی
3900319475328460021050
3900319475328460021050
No