Pharyngitis is infection and inflammation of the pharynx. It is usually viral. Bacterial pharyngitis is associated with Streptococcus pyogenes (will not have a significant cough)
- Signs and symptoms
- Sore throat
- Odynophagia
- Fever
- Physical examination
- Cervical lymphadenopathy (76%)
- Pharyngeal exudate (39%)
- Investigations
- Rapid strep test: best initial test
- Pharyngeal culture: most accurate test
- Rapid antigen test for influenza
- Monospot test for mononucleosis
- Treatment
- Supportive if viral
- Penicillin or Azithromycin if bacterial
- Tonsillectomy if recurrent
- Complications of bacterial pharyngitis
- Post-streptococcal Glomerulonephritis
- Acute Rheumatic Fever
Modified Centor Criteria
| CENTOR | Component |
|---|---|
| C | Cough absent |
| E | Exudate (pharyngeal) |
| N | Nodes (tender, cervical) |
| T | Temperature (fever) |
| OR | Young OR Old. Ages 3-14 (+1), 15-44 (0), ≥ 45 (-1) |
| Score | Likelihood | Intervention |
|---|---|---|
| 0 | <2.5% | No test/treatment |
| 1 | 5-10% | No test/treatment |
| 2 | 11-17% | Rapid antigen test |
| 3 | 18-35% | Rapid antigen test or treat empirically |
| ≥ 4 | 51-53% | Rapid antigen test or treat empirically |
