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In the pediatric population previously diagnosed positive for allergies, three clinical signs have high specificity and sensitivity for distinguishing airway infections and allergies: the persistence of symptoms, fever, and nasal secretions.

Respiratory disorders are prevalent in the pediatric population. Additionally, there is an overlapping of symptoms of airway infections and allergies in the allergic pediatric population, which can make diagnosis challenging. For prompt and accurate diagnosis and treatment of these disorders, it is important for clinicians to employ simple methods to determine allergen exposure or the cause of infection manifesting as airway symptoms.

This study, published in the Sri Lanka Journal of Child Health, evaluated the diagnostic significance of three clinical signs, including nasal secretions, fever, and the persistence of symptoms, as distinguishing factors for allergen exposure or infection in allergic pediatric patients who report airway symptoms. This study included individuals who reported airway symptoms and were diagnosed with allergies via food elimination and provocation, and through skin testing.

The study included 60 patients, out of which 60% were male. Based on the laboratory tests, including a complete blood count, a polymerase chain reaction of the nasopharyngeal swab, and C-reactive protein, 26 patients demonstrated airway infection and 34 patients did not have an infection. Out of 34 patients with no infection 28 demonstrated the three clinical signs of allergy based on non-infectious laboratory markers. Among the patients who were diagnosed with an infection, 77% had positive viral PCR, 11.5% had leukocytosis, and 11.5% were CRP-positive. The viruses included the bocavirus, coronavirus, parainfluenza virus, rhinovirus, and respiratory syncytial virus.

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In summary, three clinical signs, including time of persistence of symptoms, fever, and nasal secretions, are effective at distinguishing allergen exposure and airway infection in the allergic pediatric population who report the development of airway symptoms. These are associated with high sensitivity and specificity values for identifying infections and allergies in children. Further studies may include data obtained from the objective assessment of the children by the physicians and include a larger pool of study participants from various racial and ethnic backgrounds to mediate the generalizability of the study results.

Reference

Yulianti, R., Endaryanto, A., Hikmah, Z., Setyoningrum, R.A. and Shimizu, K., 2022. Three clinical signs to distinguish allergies or infections in allergic children with airway symptoms. Sri Lanka Journal of Child Health, 51(4), pp.542–546. DOI:http://doi.org/10.4038/sljch.v51i4.10367