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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

The sensitivity and specificity of findings for Acute Streptococcal Pharyngitis are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Sensitive and Specific Findings
Finding	Result	Sensitivity	Specificity
[ + ] Throat Culture	+ 0 -	100%	100%
Study: JAMA. 2004 Apr 7;291(13):1587-95. PMID: 15069046
[ + ] Modified Centor Criteria	+ 0 -	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
[ + ] Rapid Streptococcal Antigen Test	+ 0 -	91.1%	89%
Study: no study specified.

Specific Findings
Finding	Result	Sensitivity	Specificity
[ + ] Rapid Streptococcal Antigen Test	+ 0 -	83%	99%
Study: JAMA. 2004 Apr 7;291(13):1587-95. PMID: 15069046
[ + ] hearing loss	+ 0 -	20%	93%
>100.5F Study: Acad Emerg Med. 2000 Oct;7(10):1104-9. PMID: 11015241
[ + ] Centor Criteria	+ 0 -	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	Result	Sensitivity	Specificity
[ + ] Physical Exam	+ 0 -	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	+ 0 -	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	+ 0 -	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