title: A scoring system for management of acute pharyngo-tonsillitis in adults.
abstract: OBJECTIVE
  The aim of this study was to develop and evaluate a scoring system for the management of acute pharyngo-tonsillitis.
  
  
  METHODS
  We conducted a prospective study between May 2004 and June 2005. Patients with acute pharyngo-tonsillitis were evaluated for causative pathogens and were assessed clinical symptoms and pharyngo-tonsillar finding by a clinical scoring system.
  
  
  RESULTS
  A total 214 adult patients were enrolled in this study. Streptococcus pyogenes were identified at 13.6%. Thirty-one viruses were also identified by PCR. They were adenovirus (4.8%), influenza virus (1.0%), RS virus (6.3%), and human metapneumovirus (2.9%). Numbers of total white blood cells and levels of C-reactive protein showed a significant positive correlation with clinical scores (p<0.001) and were also higher in cases with S. pyogenes. The clinical scores rapidly improved after the antimicrobial treatments in moderate cases and severe cases.
  
  
  CONCLUSIONS
  The current study strongly suggested that the clinical scoring system reflected disease severity well and would be very useful for evaluating clinical course and decision making for the antimicrobial treatment of acute pharyngo-tonisllitis.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, 811-1 Wakayama-shi, Wakayama 641-8510, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Suzumoto
authors.forename: Muneki
authors.initials: M
authors.lastname: Hotomi
authors.forename: Dewan S
authors.initials: DS
authors.lastname: Billal
authors.forename: Keiji
authors.initials: K
authors.lastname: Fujihara
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Harabuchi
authors.forename: Noboru
authors.initials: N
authors.lastname: Yamanaka
mesh_terms: D000208:Acute Disease; D000234:Adenoids; D000257:Adenoviridae Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D007251:Influenza, Human / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012107:Research Design / Q000706:statistics & numerical data*; D013290:Streptococcal Infections / Q000150:complications / Q000188:drug therapy; D013297:Streptococcus pyogenes / Q000302:isolation & purification; D014069:Tonsillitis / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D014777:Virus Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D002097:C-Reactive Protein
references.citation: Clin Infect Dis. 2002 Jul 15;35(2):113-25
references.pmid: 12087516
references.citation: JAMA. 1985 Aug 16;254(7):925-9
references.pmid: 3894705
references.citation: J Clin Microbiol. 2006 Aug;44(8):2739-42
references.pmid: 16891486
references.citation: Eur J Clin Pharmacol. 1992;43(6):581-5
references.pmid: 1493837
references.citation: J Clin Microbiol. 2003 Aug;41(8):3467-72
references.pmid: 12904340
references.citation: Fam Pract. 1996 Jun;13(3):317-21
references.pmid: 8671142
references.citation: Am J Dis Child. 1972 Sep;124(3):352-8
references.pmid: 5056872
references.citation: JAMA. 2001 Sep 12;286(10):1181-6
references.pmid: 11559262
references.citation: J Clin Microbiol. 1990 Feb;28(2):165-9
references.pmid: 2179252
references.citation: Br J Gen Pract. 1996 Oct;46(411):589-93
references.pmid: 8945796
references.citation: BMC Med Inform Decis Mak. 2006 Mar 13;6:14
references.pmid: 16533386
references.citation: Scand J Prim Health Care. 1997 Sep;15(3):149-55
references.pmid: 9323783
references.citation: Ann Intern Med. 1989 Apr 15;110(8):612-6
references.pmid: 2494921
references.citation: Am J Dis Child. 1977 May;131(5):514-7
references.pmid: 855837
references.citation: CMAJ. 1998 Jan 13;158(1):75-83
references.pmid: 9475915
references.citation: J Fam Pract. 2000 Jan;49(1):34-8
references.pmid: 10678338
references.citation: JAMA. 1986 May 16;255(19):2638-42
references.pmid: 3517397
references.citation: Med Decis Making. 1981;1(3):239-46
references.pmid: 6763125
references.citation: BMJ. 1997 Aug 9;315(7104):350-2
references.pmid: 9270458
references.citation: N Engl J Med. 2001 Jan 18;344(3):205-11
references.pmid: 11172144
references.citation: BMJ. 1997 Mar 8;314(7082):722-7
references.pmid: 9116551
references.citation: JAMA. 1985 Mar 1;253(9):1271-4
references.pmid: 3918190
references.citation: BMJ. 1999 Sep 18;319(7212):736-7
references.pmid: 10487997
references.citation: Ann Intern Med. 2001 Mar 20;134(6):506-8
references.pmid: 11255529
references.citation: Clin Infect Dis. 1997 Sep;25(3):574-83
references.pmid: 9314443
references.citation: J Clin Microbiol. 2003 Jan;41(1):100-5
references.pmid: 12517833
references.citation: Ann Intern Med. 2001 Mar 20;134(6):479-86
references.pmid: 11255524
references.citation: BMJ. 1998 Sep 5;317(7159):637-42
references.pmid: 9727992
references.citation: JAMA. 2000 Dec 13;284(22):2912-8
references.pmid: 11147989
references.citation: Ann Intern Med. 2001 Mar 20;134(6):509-17
references.pmid: 11255530
references.citation: Ann Intern Med. 2002 Mar 19;136(6):489-90
references.pmid: 11900507
references.citation: J Clin Microbiol. 1993 Apr;31(4):804-7
references.pmid: 8463390
references.citation: Clin Infect Dis. 2002 Jul 15;35(2):126-9
references.pmid: 12087517
references.citation: Pediatr Infect Dis J. 1999 Dec;18(12):1069-72
references.pmid: 10608626
references.citation: Br J Gen Pract. 1997 May;47(418):280-4
references.pmid: 9219402
references.citation: Br J Gen Pract. 1996 Aug;46(409):461-4
references.pmid: 8949324