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Acute Streptococcal Pharyngitis: Sensitivity and Specificity

Introduction: None written.

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Tags: Infection Tag this Diagnosis.

Differential Diagnoses include: Kawasaki Disease, Viral Pharyngitis

Prevalence

Population / CalculatorPrevalence Comments / Study / Link
Patients with sore throat 41.5% Br J Gen Pract. 2005 Aug;55(517):615-9. PMID: 16105370
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The sensitivity and specificity of findings for Acute Streptococcal Pharyngitis are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

Finding SensitivitySpecificity Comments, Study
Throat Culture Edit 100%100%

Study: JAMA. 2004 Apr 7;291(13):1587-95. PMID: 15069046

Modified Centor Criteria Edit 85%92%

=>2 criteria:

  • history of objective fever (>38C)
  • exudative pharyngitis
  • lack of cough
  • tender cervical LAD
  • +1 for <=15 years old, -1 for >45 years old
  • Differential Diagnosis: Viral Pharyngitis

    Study: CMAJ. 2000 Oct 3;163(7):811-5. PMID: 11033707

    rather similar results also in JAMA. 2004 Apr 7;291(13):1587-95. PMID: 15069046

    Specific Findings

    Finding SensitivitySpecificity Comments, Study
    Rapid Streptococcal Antigen Test Edit 83%99%

    Study: JAMA. 2004 Apr 7;291(13):1587-95. PMID: 15069046

    Fever Edit 20%93%

    >100.5F

    Study: Acad Emerg Med. 2000 Oct;7(10):1104-9. PMID: 11015241

    Centor Criteria
    Duplicate Edit
    15%90%

    =4 criteria:

  • subjective or objective fever (>38C)
  • exudative pharyngitis
  • lack of cough
  • tender cervical LAD
  • Study: Br J Gen Pract. 2005 Aug;55(517):615-9. PMID: 16105370

    Poorly Diagnostic Findings

    Finding SensitivitySpecificity Comments, Study
    Physical Exam Edit 71%77%

    all 4: Tender Adenopathy, Pharyngeal Exudates, Pharyngeal Erythema, and Enlarged Tonsils

    Study: Acad Emerg Med. 2000 Oct;7(10):1104-9. PMID: 11015241

    Centor Criteria
    Duplicate Edit
    33%77%

    =3 criteria:

  • subjective or objective fever (>38C)
  • exudative pharyngitis
  • lack of cough
  • tender cervical LAD
  • Study: Br J Gen Pract. 2005 Aug;55(517):615-9. PMID: 16105370

    Centor Criteria
    Duplicate Edit
    48%67%

    >=3 criteria:

  • subjective or objective fever (>38C)
  • exudative pharyngitis
  • lack of cough
  • tender cervical LAD
  • Study: Br J Gen Pract. 2005 Aug;55(517):615-9. PMID: 16105370