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  • Title: Diagnosis of group A beta-hemolytic Streptococcus using the Breese clinical scoring system.
    Author: Karacan M, Karakelleoğlu C, Orbak Z.
    Journal: South Med J; 2007 Dec; 100(12):1192-7. PubMed ID: 18090960.
    Abstract:
    This study was planned to determine the effectiveness of the Breese scoring system for the diagnosis of streptococcal pharyngitis and to evaluate its significance in different age groups. The research population was divided into two age groups. Group 1 consisted of children aged three and below and group 2 comprised children over three years of age. All of them were then evaluated using both the Breese scoring system and throat swab cultures. In group 1, there was no difference between the mean Breese scores of group A beta-hemolytic Streptococcus (GABHS)-positive and negative patients. However, in group 2, the mean Breese scores were higher in GABHS-positive patients than in GABHS-negative patients (P < 0.001). The diagnostic value of the Breese scoring system in group 1 was sensitivity, 3.4%; specificity, 93.6%; positive predictive value, 18.2%; and negative predictive value, 70.1%. In group 2, sensitivity was 68.8%; specificity, 82.5%; positive predictive value, 78.8%; and negative predictive value, 73.7%. The results indicate that the Breese scoring system is still a useful scoring system for streptococcal pharyngitis in children over three years of age, and may help in deciding whether or not to take a throat-swab culture. A score >29 can be used as an indication for antibiotherapy. So it seems to be a useful marker for decision-making regarding antibiotherapy in emergency departments.
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