Streptococcal Acute Tonsillitis Clinical Trial
Official title:
Procalcitonin-guided Detection of Streptococcal Acute Tonsillitis
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.
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.
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Observational Model: Case Control, Time Perspective: Prospective