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Diagnostic Criteria for Acute Pharyngitis
Adults
Clinical suspicion of streptococcal
pharyngitis (e.g., fever, tonsillar
swelling, exudate, enlarged/tender anterior
cervical lymph nodes, absence of cough or
coryza) with
-
History of rheumatic
fever or
-
Documented household
exposure or
-
Positive rapid strep
screen
Children
Clinical suspicion of streptococcal
pharyngitis (e.g., tonsillar swelling,
exudate, enlarged/tender anterior cervical
lymph nodes, absence of coryza) with
-
History of rheumatic
fever or
-
Documented household
exposure or
-
Positive rapid strep
screen or
-
Positive throat culture
(for those with negative rapid strep
screen)
Streptococcal Pharyngitis Score (Sore Throat Score)
|
Symptoms |
Points |
|
Fever (subjective or
measured in office) |
1 |
|
Absence of cough |
1 |
|
Tender anterior cervical
adenopathy |
1 |
|
Tonsillar swelling or
exudates1 |
1 |
|
Age
Younger than 15 years
15
to 45 years
Older than 45 years |
+1
0
-1 |
SCORING:
-
0 or
-1
points: streptococcal infection ruled out (2
percent);
-
1 to 3 points: order rapid test and treat
accordingly;
-
4 to 5 points: probable streptococcal
infection (52 percent), consider empiric
antibiotics.
Related Criteria
Case
Definition of Staphylococcal Toxic
Shock Syndrome (TSS)
Case Definition of Streptococcal
Toxic-Shock Syndrome (Streptococcal TSS)
and Necrotizing Fasciitis
More...
References:
-
Vincent MT, Celestin N,
Hussain AN. Pharyngitis. Am Fam Physician.
2004 Mar 15;69(6):1465-70.
[Medline]
-
McIsaac WJ, Goel V, To
T, Low DE. The validity of a sore throat
score in family practice. CMAJ. 2000 Oct
3;163(7):811-5.
[Medline]
-
Neuner JM, Hamel MB,
Phillips RS, Bona K, Aronson MD. Diagnosis
and management of adults with pharyngitis.
A cost-effectiveness analysis. Ann Intern
Med. 2003 Jul 15;139(2):113-22.
[Medline]
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Created: February 21, 2005
Last Modified:
01-22-2010 |
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