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Abstract(s)
Background: A faringoamigdalite aguda é um dos diagnósticos mais frequentemente
realizados pelos Pediatras. Esta entidade é na sua grande maioria de etiologia viral no
entanto, 15 a 20% é de etiologia bacteriana, sendo esta última a que mais preocupa os
clínicos pelo seu risco de complicações. A distinção clínica é por vezes bastante difícil,
levando muitas vezes ao seu sobre diagnóstico e prescrição de antibióticos que
conduzem ao problema em ascensão das resistências aos antibióticos.
Objectivos: Avaliar a presença de concordânci a entre os dados clínicos recolhidos
durante o estudo e os obtidos após a pesquisa bibliográfica.
Métodos: Estudo retrospectivo através da recolha dos dados clínicos relativos a todas
a crianças que realizaram o teste rápido antigénico para o streptococcus do grupo A
durante o mês de Dezembro, com clínica de faringoamigdalite e idade inferior a 15
anos. Os dados colhidos incluíam as variáveis idade, sexo, dados relevantes da
anamese, exploração física, resultado da prova antigénica para streptococcus do grupo
A bem como a terapêutica instituída.
Resultados: As crianças com teste rápido antigénico para o streptococcus do grupo A
positivo apresentam um predomínio de odinofagia (86%) e eritema faríngeo (70,2%).
Os sintomas catarrais, como a tosse estão presentes em cerca de 10% dos doentes
com resultado positivo. As crianças com idade inferior a três anos têm um quadro
clínico de odinofagia (33,3%), tosse (33,3%) e rinorreia (16,7%). Nas crianças com teste rápido antigénico negativo a odinofagia (56,6%) e a tosse
(33,3%) são os principais sintomas associados ao eritema faríngeo em 55% dos
doentes. Enquanto no exame físico o eritema e o exsudado prevalecem com 67,7% e
28,3% respectivamente.
A associação amoxicilina e ácido clavulânico foram prescritas em 51% dos casos
seguidos de amoxicilina em 41% dos casos.
Conclusão: A distinção clínica da faringoamigdalite é bastante difícil sendo baseada
unicamente pelo quadro clínico. É necessária a utilização de exames auxiliares de
diagnóstico bastante sensíveis e específicos e que demorem pouco tempo para darem
o resultado.
The pharyngo- tonsillitis is one of the most frequent diagnoses made by the Pediatricians. The etiology is most frequently viral, but 15 to 20% is bacterial, being the one which concerns the most for its complications. The distinction between both is quite difficult, leading to over diagnoses, antibiotic prescription contributing to the new epidemic, the antibiotic resistance. Objectives: Evaluating the presence of concordance between clinical data collected in the study and those obtained after the bibliographic research. Methods: The prospective study was made thru the gathering of clinical data of all the children, less than 15 years old, who had made the antigenic test for the Streptococos A between 1 and 31 of December in the Pediatric emergency service from Centro Hospitalar Cova da Beira. The data collected included the variables age, sex, relevant information from the anamnesis, physical exploration, result of the antigenic test for the Streptococos A and the treatment applied. Results: Children with a positive result in the antigenic test for the Streptococcus A presented in 86% of the cases with odinophagia , 70,2% with pharyngeal erythema and 10% with cough. Children with a positive result in the antigenic test for the Streptococcus A and with less than three years presented with odinophagia (33,3%), cough (33,3%) and rhinorrhea (16,7%). Children with a negative result in the antigenic test for the Streptococcus A, odinophagia (56,6%) and cough (33,3%) are the main clinical manifestations accompanied by pharyngeal erythema (67,7%). The association of amoxicilin and clavulanic acid was prescribed in 51% of the cases followed by amoxicilin in 41% of the cases. Conclusions: The differential diagnosis of the pharyngo-tonsillitis is quite difficult, guided only by the clinical manifestations. It is important the use of auxiliary diagnostic tests with high sensibility and specificity and with a short interval until the results.
The pharyngo- tonsillitis is one of the most frequent diagnoses made by the Pediatricians. The etiology is most frequently viral, but 15 to 20% is bacterial, being the one which concerns the most for its complications. The distinction between both is quite difficult, leading to over diagnoses, antibiotic prescription contributing to the new epidemic, the antibiotic resistance. Objectives: Evaluating the presence of concordance between clinical data collected in the study and those obtained after the bibliographic research. Methods: The prospective study was made thru the gathering of clinical data of all the children, less than 15 years old, who had made the antigenic test for the Streptococos A between 1 and 31 of December in the Pediatric emergency service from Centro Hospitalar Cova da Beira. The data collected included the variables age, sex, relevant information from the anamnesis, physical exploration, result of the antigenic test for the Streptococos A and the treatment applied. Results: Children with a positive result in the antigenic test for the Streptococcus A presented in 86% of the cases with odinophagia , 70,2% with pharyngeal erythema and 10% with cough. Children with a positive result in the antigenic test for the Streptococcus A and with less than three years presented with odinophagia (33,3%), cough (33,3%) and rhinorrhea (16,7%). Children with a negative result in the antigenic test for the Streptococcus A, odinophagia (56,6%) and cough (33,3%) are the main clinical manifestations accompanied by pharyngeal erythema (67,7%). The association of amoxicilin and clavulanic acid was prescribed in 51% of the cases followed by amoxicilin in 41% of the cases. Conclusions: The differential diagnosis of the pharyngo-tonsillitis is quite difficult, guided only by the clinical manifestations. It is important the use of auxiliary diagnostic tests with high sensibility and specificity and with a short interval until the results.
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Keywords
Faringoamigdalite Faringoamigdalite - Exames auxiliares de diagnóstico Faringoamigdalite - Antibioterapia
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Universidade da Beira Interior