SOVREMENNAYA PEDIATRIYA.2019.3(99):8-12; doi 10.15574/SP.2019.99.8

Koloskova О. К., Ivanova L. А., Horbatiuk I. B.
Higher State Educational Establishment of Ukraine «Bukovinian State Medical University», Chernivtsi

Objective: to study etiological diagnostics of acute tonsillopharyngitis in children and determine diagnostic value of the common clinical and paraclinical indices in verification of non$streptococcal etiology of tonsillopharyngitis in order to improve its treatment.

Materials and methods. 102 children with tonsillopharyngitis were examined. Two clinical groups of observation were formed on the basis of the results of analyses of inoculations from tonsillar surface on beta-hemolytic group A streptococcus. The first group (І) included 68 patients with non-streptococcal acute tonsillopharyngitis, and the second one (ІІ) included 34 children with found inoculated beta-hemolytic group A streptococcus — streptococcal acute tonsillopharyngitis (sATP).

Results. In spite of lack of considerable differences in clinical manifestation of acute tonsillopharyngitis (ATP), on the moment of admission they were more pronounced in children with streptococcal ATP. The main sign was increased body temperature, which was low-grade in 20.9% of patients from І group, and in 50.7% of cases it was higher than 38,5°С. The representatives of ІІ group developed such fever in 36.1% (P<0.05) and in 57.6% of observations (P>0.05) respectively. Cough available in children with inflammation of the palatine tonsils was indicative of non-streptococcal etiology of the inflammatory process with the test specificity 70.5% and predicted value of a positive result 60.0% (95% CІ 46.4–72.6). At the onset of the disease, the exudate component of ATP was pronounced practically similarly in children from the groups of comparison. It was (score) in patients from І clinical group 2.6±0.17, and 2.9±0.23 in children from the group of comparison (P>0.05). In children from І clinical group peripheral blood leukocytosis more than 10.0 g/L was found in 29.4% cases, stab neutrophils more than 15.0% — in 47.1% cases, segmental leukocytes more than 50.0% — in 48.5% cases. In patients suffering from streptococcal tonsillopharyngitis the above markers of the peripheral blood leukogram were found to be in 44.1% (P<0.05), 38.2% (P>0.05), 41.1% (P>0.05) of cases respectively.

Conclusion. In patients with non$streptococcal acute tonsillopharyngitis febrile body temperature was found reliably rarely (OR=4.1), swelling and coating of tonsils (OR=1.7), enlargement and painfulness of the cervical lymph nodes, cough were found less frequently.

Key words: acute tonsillopharyngitis, children, clinical signs.

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Article received: Dec 19, 2018. Accepted for publication: Mar 25, 2019.