Acute Streptococcal Pharyngitis: Sensitivity and Specificity

Introduction: None written.

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.

Viral Pharyngitis

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

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

Untagged

Finding	Sensitivity	Specificity	Comments, Study
Centor Criteria Duplicate	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
Centor Criteria Duplicate	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
Centor Criteria Duplicate	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
hearing loss	20%	93%	>100.5F Study: Acad Emerg Med. 2000 Oct;7(10):1104-9. PMID: 11015241
Physical Exam	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
Rapid Streptococcal Antigen Test Duplicate	83%	99%	Study: JAMA. 2004 Apr 7;291(13):1587-95. PMID: 15069046
Rapid Streptococcal Antigen Test Duplicate	91.1%	89%	Study: no study specified.
Throat Culture	100%	100%	Study: JAMA. 2004 Apr 7;291(13):1587-95. PMID: 15069046