DIAGNOSTIC SIGNIFICANCE OF CLINICAL AND LABORATORY INDICES IN VERIFICATION OF ACUTE NON-STREPTOCOCCAL TONSYLOPHARYNGITIS IN CHILDREN

Abstract

The aim of the study - to study the diagnostic significance of clinical and laboratoryparameters in the verification of acute non-streptococcal tonsillopharyngitis in childrenin order to determine rational treatment tactics.Material and methods. To achieve this aim, two clinical groups were formed. The first (I,main) group consisted of 66 patients with acute tonsillopharyngitis of non-streptococcaletiology, as evidenced by the negative result of bacterial examination of the lavage ofthe pharynx and posterior pharyngeal wall. The second (II) clinical group included 32children diagnosed with "streptococcal acute tonsillopharyngitis".Results. The total score on the McIsaac scale, which did not exceed 2 points, wasregistered in 15.2 ± 4.4% of group I patients and 6.2 ± 4.2% of patients in the comparisongroup. The sensitivity of the method was 15.2%, specificity – 93.7%, positive and negativepredicted value – 83.3% and 34.8%, respectively, with odds ratio – 2.6 [95% CI: 0.5-13,0]. The average content of leukocytes in the blood less than 8.9 × 109/l was registeredin 57.6% of patients of group I and 48.8% of representatives of the second (P˃0.05). Thesensitivity of this laboratory test in the detection of non-streptococcal tonsillopharyngitiswas 57.6%, specificity – 55.6%, predicted value of a positive result – 54.1%, predictedvalue of a negative result – 59.1%. The relative risk of non-streptococcal etiology of ATPwhen registering a patient with less than 8.9 × 109/l of peripheral blood leukocytes was1.7 (95% CI 0.9-2.9), the absolute risk – 0.1 with odds ratio of 1.7 (95% CI 0.9-2.9).Conclusions. The proposed clinical scales and some paraclinical parameters haveinsufficient diagnostic value, so they cannot be used independently for early verificationof non-streptococcal etiology of tonsillopharyngitis in children.