THE DIAGNOSTIC VALUE OF “CENTOR CRITERIA” IN CHILDREN WITH GROUP A BETA HEMOLYTIC STREPTOCOCCUS TONSILLOPHARYNGITIS
Mona Orra*, Amal Naous, Soha Ghanem, Bassem Abou Merhi and Mariam Rajab
ABSTRACT
Background: Centor criteria (fever >38.5°C, swollen, tender anterior cervical lymph nodes, tonsillar exudate and absence of cough) include a scoring system used to assess the probability of group A β hemolytic Streptococcus (GABHS) as the origin of sore throat, and it is developed for adults. Up till now, there’s no graded scoring system established for children with suspected GABHS pharyngitis. Thus, it is important to evaluate the correlation between Centor criteria and presence of GABHS in children with sore throat. Objectives: This study was intended to test the Centor Criteria as a scoring system for GABHS in children and assess its diagnostic value to guide us toward whether to perform to a rapid diagnostic point of care (POC) test/throat culture in pediatric patients presenting with sore throat. In addition to assessing the impact of this scoring system with the support of practical laboratory tests: the WBC and the CRP. Methods: We proposed to carry out a retrospective cross-sectional study at the Makassed General Hospital in children (aged 3–15 years) diagnosed with tonsillitis. We recorded Centor scoring in addition to white blood cell count (WBC), C-reactive protein (CRP), rapid antigen detecting test and throat culture. Results: 484 children with tonsillitis were enrolled between 1st January 2010 and 31st July 2017. GAS was positive in 129 (26%) cases and negative in 358 (74%). In GAS cases, two of the Centor criteria were observed to be positive in 4 (3.1%), while 122 (94.6%) cases met three to four Centor criteria with a significant p-value (<0.001).The specificity of having three/four criteria was found to be 62 % and increased to 97% after including CRP and WBC. Conclusion: Centor criteria could be a tool to be used to reduce unnecessary rapid diagnostic point of care (POC) test/throat culture in children presenting with sore throat.
Keywords: Centor critera; Group A Beta Hemolytic Streptoccocus, Tonsillopharyngitis.
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