Impact of the use of rapid antigen detection test in the diagnosis and treatment of acute pharyngitis in pediatric emergency room

Abstract

Methods: Retrospective analysis of 11 years bronchoscopy data in the Pediatric Pulmonologic Institute of Hadassah University Hospital and prospective telephonic follow up. Results: Out of 3700 bronchoscopies (mean age 2.5 years), 2268 (61%) were performed due to suspected airway obstruction. Tracheo or Broncho malacia was found in 827 children, of them, 102 children performed chest CT angiography, of them, 47 performed also echocardiography. Telephone follow up was performed to 58 children (mean 4.5 years after bronchoscopy). Thirteen children underwent operation due to double aortic arch (n =10), aberrant innominate artery (n =1), right aortic arch with fibrotic band (n =1), severe right primary bronchomalacia (n = 1). All these children had moderate to severe airway obstruction (>50%) by bronchoscopy and CT. Echocardiography diagnosed 9 out of 10 vascular rings. Conclusions: Echocardiography should be performed in every pulsate tracheo-bronchomalacia. Mild (<50%) airway obstruction can be followed up. In moderate to severe airway obstruction with continues respiratory symptoms, MRI or CT focused to the level of the pathology should be performed. Using this workup diagnosis the use of CT will be decreased in 40% at least.