HALITOSIS AS AN ADDITIONAL CLINICAL MARKER OF STREPTOCOCCAL TONSILLITIS IN CHILDREN: OUTPATIENT OBSERVATION
DOI:
https://doi.org/10.11603/24116-4944.2025.2.15820Keywords:
halitosis, streptococcal tonsillitis, pediatric diagnosis, group A β-hemolytic streptococcus (GABHS), oral malodor, chronic tonsillitis, rapid antigen test, bacterial pharyngitis, outpatient pediatrics, diagnostic markersAbstract
The aim of the study – to evaluate the clinical significance of halitosis as a supplementary marker of streptococcal tonsillitis in children aged 3–18, including its correlation with confirmed Group A β-hemolytic streptococcal (GABHS) infection.
Materials and Methods. A total of 279 children presenting with symptoms of acute or chronic tonsillopharyngitis were assessed between January and May 2025. Clinical examination included halitosis evaluation and a rapid antigen test for GABHS. Patients with non-streptococcal or unrelated conditions were excluded.
Results and Discussion. Of 190 children with confirmed streptococcal infection, halitosis was observed in 128 (67.4 %). The symptom was most prevalent in follicular (89.3 %) and lacunar (78.5 %) tonsillitis and during exacerbations of chronic tonsillitis (81 %). Younger children (7–10 years) exhibited the highest prevalence (73.2 %). Halitosis intensity was moderate in 50.8 % and severe in 27.3 % of cases. A strong correlation was found between halitosis and positive rapid streptococcal test results (87.5 % of halitosis cases were GABHS-positive), versus 36 % among viral cases.
Conclusions. Halitosis may be a valuable, easily detectable marker for streptococcal pharyngotonsillitis in children, especially in settings with limited diagnostic tools. Its integration into clinical algorithms could improve early identification of bacterial infections and guide antibiotic prescribing, supporting efforts to reduce antibiotic resistance.
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