检查 针对 A 型链球菌的快速抗原检测试验可在床边立即进行。与咽拭子培养相比,其敏感性和特异性分别是 70%-90% 和 95%。[3]Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012;55:e86-e102.http://cid.oxfordjournals.org/content/55/10/e86.longhttp://www.ncbi.nlm.nih.gov/pubmed/22965026?tool=bestpractice.com[8]Cohen JF, Bertille N, Cohen R, et al. Rapid antigen detection test for group A streptococcus in children with pharyngitis. Cochrane Database Syst Rev. 2016;(7):CD010502.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010502.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/27374000?tool=bestpractice.com[13]Lean WL, Arnup S, Danchin M, et al. Rapid diagnostic tests for group A streptococcal pharyngitis: a meta-analysis. Pediatrics. 2014;134:771-781.http://pediatrics.aappublications.org/content/134/4/771.longhttp://www.ncbi.nlm.nih.gov/pubmed/25201792?tool=bestpractice.com
若抗原试验结果阴性,则应进行咽拭子培养,尤其是在风湿热患病风险增加的儿童。
检测阳性,但无特征性症状(发热、无咳嗽、扁桃体渗出液和压痛性颈部淋巴结肿大)很可能表示定植,无临床相关性。对无适当症状的患者进行检测常导致误诊和抗生素的不当使用。