A comparison of clinical characteristics between adenoviral and group a streptococcal pharyngitis in children

Abstract

Purpose: To compare the clinical characteristics and laboratory finding between adenoviral and group A streptococcal (GAS) pharyngitis. Methods: A retrospective review of medical records was performed in the patients with adenovirus infection among those who were admitted for febrile respiratory disease from January 2011 to July 2013 and GAS pharyngitis among those who visited for symptoms of scarlet fever from August 2006 to July 2013. Results: 179 patients (AV1 group) were diagnosed with adenoviral pharyngitis and 37 (AV2 group) of these patients had adenovirus single infection. 26 patients (GAS group) were diagnosed with scarlet fever. Adenoviral infection (AV2 group) developed in younger patients compared to GAS group (2.8±2.1 years vs. 5.4±1.8 years, P =0.000). Total durations of fever and admission were longer in AV2 (6.3±2.6 days vs. 3.3±1.9 days, P =0.000; 4.1±1.2 days vs. 1.9±1.8 days, P =0.000, respectively). WBC counts were higher in AV2 (11,449±5,680 cells/mm2 vs. 6,722±6,941 cells/mm2, P =0.000). CRP was not significantly different between AV2 and GAS group (3.8±3.2 mg/dL vs. 5.2±5.1 mg/dL, P =0.368). No difference was found between two groups in the percentage of antibiotics use (91.9% vs. 100%, P =0.261). Conclusion: Clinical characteristics and measures of inflammation in the laboratory findings were similar between adenoviral and GAS pharyngitis group. It is necessary to conduct the test for respiratory virus and bacteria in early stage to differentiate in the pharyngitis patients with leukocytosis and elevation of CRP level.