Introduction: GAS pharyngitis is both antecedent for invasive streptococcal infection and post infectious immunologic complication of Rheumatic fever/RHD, a leading cause of cardiovascular morbidity and mortality in many developing parts of the world.                

Aims and Objective: To analyse the usefulness of symptoms and signs in assessing the risk of streptococal pharygitis and to correlate McISSAC score with throat swab culture.   

Results: About 50% of patient tested positive for GABHS have Mc-Issac score of 5, whereas 25% of positive tested patient have score of 4 and again 25% of positive patient have score of 3. The chi-square test of association is significant. Therefore, 75% of positive GABHS findings have Mc-Issac score of 4 and 5.

Conclusion: Individual signs and symptoms are not powerful enough to discriminate GABHS pharyngitis from other types of sore throat. The McIsaac score is well calibrated clinical prediction rule for estimating the probability of GABHS pharyngitis. The result of McIsaac score and culture finding of GABHS have close association with each our.

Keywords: McIsaac score, GABHS, Throat swab culture and sensitivity.

1. W J McIsaac, D White, D Tannenbaum, and D E Low A clinical score to reduce unnecessary antibiotic use in patients with sore throat CMAJ. 1998 Jan 13; 158(1): 75–83.
2. Ana Gabriela P. dos Santos; Eitan N. Berezin Comparative analysis of clinical and laboratory methods for diagnosing streptococcal sore throat J. Pediatr. (Rio J.) vol.81 no.1 Porto Alegre Jan./Feb. 2005
3. Amber Hanif Palla, Rafeeq Alam Khan, Anwar H. Gilani Overprescription of antibiotics for adult pharyngitisis prevalentin developing countries but can be reduced using McIsaac modification of Centor scores: a cross-sectional study
4. Ching-TangShih Ching-ChiangLin Chung-ChingLu Evaluation of a Streptococcal Pharyngitis Score in Southern Taiwan Volume 53, Issue 1, February 2012, Pages 49-54.
5. Yavuz FURUNCUOĞLU1, Filiz SAĞLAM, Ahmet KUTLUHAN3 Acute exudative tonsillitis in adults: the use of the Centor score and some laboratory testsTurk J Med Sci (2016) 46: 1755-1759 © TÜBİTAK doi: 10.3906/sag-1510-93.
6. Imanuel Y. Malino, Dwi Lingga Utama, Yati Soenarto McIsaac criteria for diagnosis of acute group-A β-hemolytic streptococcal pharyngitis VOLUME53 September  2013      Number 5
7. ElenaChiappini MD, PhD Nicola PrincipiMD , Italian panel on the Management of pharyngitis in children.Management of Acute Pharyngitis in Children: Summary of the Italian National Institute of Health Guidelines,Volume 34, Issue 6, June 2012, Pages 1442-1458.e2.
8. Richelle J. Cooper, MD, MSHS; Jerome R. Hoffman, MA, MD; John G. Bartlett, MD; Principles of Appropriate Antibiotic Use for Acute Pharyngitis in Adults: Background POSITION PAPERS|20 MARCH 2001
9. BETH A. CHOBY, MD, University of Tennessee College of Medicine–Chattan-ooga, Chattanooga, Tennessee Diagnosis and Treatment of Streptococcal Pharyngitis Am Fam Physician. 2009 Mar 1; 79(5):383-390.
10. Susanna Felsenstein, Diala Faddoul,  Richard Sposto, Molecular and Clinical Diagnosis of Group A Streptococcal Pharyngitis in Children J Clin Microbiol. 2014 Nov; 52(11): 3884–3889. doi:  1128/JCM.01489-14
11. Tony MO Bakare and Peter Schattner. The usefulness of a clinical 'scorecard' in managing patients with sore throat in general practice Asia Pac Fam Med. 2010; 9(1): 9. Published online 2010 Jul 29. doi:  10.1186/1447-056X-9-9.

S.Usha

Post Graduate, Department of ENT,

RMMCH, Chidambaram-608002,Tamilnadu