USE OF EXPRESS BIOCHEMICAL TESTS TO DETERMINE THE ETIOLOGY OF ACUTE TONSILLITIS IN THE PERSPECTIVE OF A DIAGNOSTIC APPROACH

Abstract

Introduction. The diagnosis of acute tonsillitis remains a significant challenge in modern medicine due to the variety of infectious agents involved. Differentiation of the etiology of acute tonsillitis is a critical step in ensuring appropriate treatment for patients. Without accurate determination of the cause, there is a higher risk of unwarranted antibiotic use in cases of viral infections. This contributes to the development of antibiotic resistance, disruption of normal microbiota, and the occurrence of side effects. The aim of the study is to determine the type of pathogen in patients with oropharyngeal infection by using rapid tests to increase the efficiency of diagnosis and optimize the choice of therapeutic strategy. Research Methods. A total of 46 patients (mean age 25,97±7,71 years) with upper respiratory tract infections were examined, all of whom were treated by primary care physicians. Immunochromatographic tests were employed to determine the etiology of the pathogens. These tests included antigen panels for adenoviruses, respiratory syncytial virus, influenza viruses A/B, Covid-19, and group A Streptococcus. Results and Discussion. According to the results of rapid tests conducted on patients with symptoms of acute respiratory infections, 10,41% of cases were of bacterial origin, as confirmed by streptococcal tests, 70,83% were viral, and 18,75% had undiagnosed etiology. Adenoviral infection was the most common, diagnosed in 12 patients (26,7%), and was associated with a statistically significant increased risk of infection (OR = 2,67) compared to the reference group. Respiratory syncytial virus (RSV) was detected in 8 patients (17,8%) with an odds ratio (OR) of 1,89. Influenza A/B (including in combination with other pathogens) was identified in 5 cases (11,1%), with an OR of 1,34. Group A Streptococcus was confirmed in 4 patients (8,9%), with an OR of 1,12. Mixed infections, such as group A Streptococcus combined with adenovirus or adenovirus with influenza A/B or influenza with RSV, were observed in 5 patients (11,1%), with an OR of 1,42. In 9 patients (20%), the etiology remained undiagnosed, serving as the reference group for statistical calculations. Conclusions. The obtained results highlight the importance of using rapid diagnostic tests to determine the etiology of pathogens causing acute tonsillitis.