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| ID | Type | Description | Link |
|---|---|---|---|
| 2007-58-0010 | Other Identifier | Danish Data Protection Agency |
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| Name | Class |
|---|---|
| Skodstrup Medical Clinic, Denmark | UNKNOWN |
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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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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Acute tonsillitis | Patients with acute tonsillitis aged 15 to 40 years meeting at least two of Centors criteria. | ||
| Healthy control patients | Control patients aged 15 to 40 years. |
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| Measure | Description | Time Frame |
|---|---|---|
| Procalcitonin | Procalcitonin from all 100 participants will be analyzed at once. | The participants will bee examined in family practice in 30 minuts, measurement results will be available after 3-4 month (average) |
| Measure | Description | Time Frame |
|---|---|---|
| Centor score | The participants will bee examined in family practice in 30 minuts, measurement results will be available after the consultation |
| Measure | Description | Time Frame |
|---|---|---|
| Cultured bacteria | In both the acute tonsillitis group and the healthy control group. | Tonsillar surface swabs obtained at time of consultation. The consultation takes about 30 minuts and results will be analyzed approx. 1 time per week. |
Patients with acute tonsillitis:
Inclusion Criteria:
Exclusion Criteria:
Control patients:
Inclusion criteria:
Exclusion Criteria:
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Patients with acute tonsillitis aged 15 to 40 years consulting their general practitioner with signs and symptoms of acute tonsillitis meeting to or more of Centors criteria.
Healthy control patients aged 15 to 40 years consulting their general practitioner in other reason than infection.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ann MG Christensen, medical student | Contact | +45 28740001 | ann.mgc@hotmail.com | |
| Tejs E Klug, MD | Contact | +45 51604046 | tejsehlersklug@hotmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Tejs E Klug, MD | Aarhus University Hospital | Study Director |
| Therese Ovesen, DMSc | Aarhus University Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Skoedstrup Medical Clinics | Recruiting | Skødstrup | 8541 | Denmark |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 16462299 | Result | Elsammak M, Hanna H, Ghazal A, Edeen FB, Kandil M. Diagnostic value of serum procalcitonin and C-reactive protein in Egyptian children with streptococcal tonsillopharyngitis. Pediatr Infect Dis J. 2006 Feb;25(2):174-6. doi: 10.1097/01.inf.0000199273.37314.b2. | |
| 19842975 | Result | Ehlers Klug T, Rusan M, Fuursted K, Ovesen T. Fusobacterium necrophorum: most prevalent pathogen in peritonsillar abscess in Denmark. Clin Infect Dis. 2009 Nov 15;49(10):1467-72. doi: 10.1086/644616. |
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Patients with acute tonsillitis:
Healthy control patients:
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| 3534166 | Result | Komaroff AL, Pass TM, Aronson MD, Ervin CT, Cretin S, Winickoff RN, Branch WT Jr. The prediction of streptococcal pharyngitis in adults. J Gen Intern Med. 1986 Jan-Feb;1(1):1-7. doi: 10.1007/BF02596317. |
| 11033707 | Result | McIsaac WJ, Goel V, To T, Low DE. The validity of a sore throat score in family practice. CMAJ. 2000 Oct 3;163(7):811-5. |
| 21036645 | Result | Rimoin AW, Walker CL, Hamza HS, Elminawi N, Ghafar HA, Vince A, da Cunha AL, Qazi S, Gardovska D, Steinhoff MC. The utility of rapid antigen detection testing for the diagnosis of streptococcal pharyngitis in low-resource settings. Int J Infect Dis. 2010 Dec;14(12):e1048-53. doi: 10.1016/j.ijid.2010.02.2269. Epub 2010 Oct 30. |
| 8243596 | Result | Begovac J, Bobinac E, Benic B, Desnica B, Maretic T, Basnec A, Kuzmanovic N. Asymptomatic pharyngeal carriage of beta-haemolytic streptococci and streptococcal pharyngitis among patients at an urban hospital in Croatia. Eur J Epidemiol. 1993 Jul;9(4):405-10. doi: 10.1007/BF00157398. |
| 15765639 | Result | Lindbaek M, Hoiby EA, Lermark G, Steinsholt IM, Hjortdahl P. Which is the best method to trace group A streptococci in sore throat patients: culture or GAS antigen test? Scand J Prim Health Care. 2004 Dec;22(4):233-8. doi: 10.1080/02813430410006675. |
| 15687433 | Result | Edmonson MB, Farwell KR. Relationship between the clinical likelihood of group a streptococcal pharyngitis and the sensitivity of a rapid antigen-detection test in a pediatric practice. Pediatrics. 2005 Feb;115(2):280-5. doi: 10.1542/peds.2004-0907. |
| 17054126 | Result | Del Mar CB, Glasziou PP, Spinks AB. Antibiotics for sore throat. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD000023. doi: 10.1002/14651858.CD000023.pub3. |
| 18830726 | Result | Rusan M, Klug TE, Ovesen T. An overview of the microbiology of acute ear, nose and throat infections requiring hospitalisation. Eur J Clin Microbiol Infect Dis. 2009 Mar;28(3):243-51. doi: 10.1007/s10096-008-0619-y. Epub 2008 Oct 2. |
| 15358827 | Result | Aliyu SH, Marriott RK, Curran MD, Parmar S, Bentley N, Brown NM, Brazier JS, Ludlam H. Real-time PCR investigation into the importance of Fusobacterium necrophorum as a cause of acute pharyngitis in general practice. J Med Microbiol. 2004 Oct;53(Pt 10):1029-1035. doi: 10.1099/jmm.0.45648-0. |
| 17403128 | Result | Jensen A, Hagelskjaer Kristensen L, Prag J. Detection of Fusobacterium necrophorum subsp. funduliforme in tonsillitis in young adults by real-time PCR. Clin Microbiol Infect. 2007 Jul;13(7):695-701. doi: 10.1111/j.1469-0691.2007.01719.x. Epub 2007 Apr 2. |
| 19949147 | Result | Centor RM. Expand the pharyngitis paradigm for adolescents and young adults. Ann Intern Med. 2009 Dec 1;151(11):812-5. doi: 10.7326/0003-4819-151-11-200912010-00011. |
| 7802743 | Result | Veasy LG, Tani LY, Hill HR. Persistence of acute rheumatic fever in the intermountain area of the United States. J Pediatr. 1994 Jan;124(1):9-16. doi: 10.1016/s0022-3476(94)70247-0. |
| 10326264 | Result | Gulich MS, Matschiner A, Gluck R, Zeitler HP. Improving diagnostic accuracy of bacterial pharyngitis by near patient measurement of C-reactive protein (CRP). Br J Gen Pract. 1999 Feb;49(439):119-21. |
| 327423 | Result | Kaplan EL, Wannamaker LW. C-reactive protein in streptococcal pharyngitis. Pediatrics. 1977 Jul;60(1):28-32. |
| 3021463 | Result | Putto A, Meurman O, Ruuskanen O. C-reactive protein in the differentiation of adenoviral, Epstein-Barr viral and streptococcal tonsillitis in children. Eur J Pediatr. 1986 Aug;145(3):204-6. doi: 10.1007/BF00446066. |
| 6763125 | Result | Centor RM, Witherspoon JM, Dalton HP, Brody CE, Link K. The diagnosis of strep throat in adults in the emergency room. Med Decis Making. 1981;1(3):239-46. doi: 10.1177/0272989X8100100304. |
| Result | Murray PR, Baron EJ, Jorgensen JH, et al. Manual of clinical microbiology. 9th ed. Washington, DC: ASM Press. 2007. |