Streptococcal Acute Tonsillitis
Conditions
Keywords
Acute tonsillitis, Procalcitonin, Streptococcal antigen test, Centor Criteria, Infection marker
Brief summary
The primary purpose of the present study is to investigate the usefulness of Procalcitonin as a supplement to the Streptococcal antigen test and Centor criteria in the differential diagnose making between Streptococcal and non-Streptococcal acute tonsillitis. Furthermore, the investigators aim to examine Procalcitonin as a diagnostic marker in acute tonsillitis due to Fusobacterium Necrophorum.
Detailed description
Acute tonsillitis is based on typical symptoms (sore throat, pain on swallowing, and fever) and clinical findings of tonsillar exudate and hyperemia. 10-20% of patients seen by their family physician, have acute tonsillitis due to streptococci group A. In Denmark, Centors criteria and the Streptococcal antigen test (Strep. A-test) are gold standard in the diagnostic process of streptococcal acute tonsillitis. Although the sensitivity and specificity of the Strep. A-test is biochemically high, its clinical reliability is reduced due to several influential factors. Moreover, studies suggest that 4-10% of patients are tested false-negative based on clinical criteria and the Strep A-test. Fusobacterium necrophorum are suspected to be the cause of acute tonsillitis in teenagers and young adults (5-15%). However, there is no rapid test available for this bacterium. Since tonsillar surface swab is not included in the diagnostic standard, family physicians get no information about infection due to Fusobacterium necrophorum or other pathogens. C-reactive protein, leukocyte count and absolute neutrophil count as diagnostic markers are examined with variable results. Procalcitonin is a relatively new marker of bacterial infection, which has the advantage of more rapid and specific induction compared to the other markers.
Interventions
None listed
Sponsors
Skodstrup Medical Clinic, Denmark
Aarhus University Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
15 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
Patients with acute tonsillitis: Inclusion Criteria: * Age between 15 and 40 years. * Subjective and objective signs of Acute Tonsillitis + presents of 2-4 Centor Criteria. * participation accept after verbal and written information.
Exclusion criteria
* Antibiotic treatment within the last month. * Other infection within the last month. * Inadequate tonsil swabs due to lack of cooperation. * Suspicion of peritonsillar abscess Control patients: Inclusion criteria: * Age between 15 and 40 years. * Participation accept after verbal and written information.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Procalcitonin | The participants will bee examined in family practice in 30 minuts, measurement results will be available after 3-4 month (average) | Procalcitonin from all 100 participants will be analyzed at once. |
Secondary
| Measure | Time frame |
|---|---|
| Centor score | The participants will bee examined in family practice in 30 minuts, measurement results will be available after the consultation |
Other
| Measure | Time frame | Description |
|---|---|---|
| Cultured bacteria | Tonsillar surface swabs obtained at time of consultation. The consultation takes about 30 minuts and results will be analyzed approx. 1 time per week. | In both the acute tonsillitis group and the healthy control group. |
Countries
Denmark
Contacts
Primary ContactAnn MG Christensen, medical student
Backup ContactTejs E Klug, MD
Outcome results
None listed