Strep Throat Dx Criteria
1. Tonsillar Exudates
2. Tender anterior cervical lymphadenopathy
3. Fever (> 100.4 F)
4. Absence of cough
ITE 2013, Q#77.
A 7-year-old male presents with a 3-day history of sore throat, hoarseness,
fever to 100°F (38°C), and cough. Your examination reveals injection of his
tonsils, no exudates, shotty lymphadenopathy, and normal breath sounds.
Which one of the following would be most appropriate?
A) Symptomatic treatment only
B) Empiric treatment for streptococcal pharyngitis
C) A rapid antigen test for streptococcal pharyngitis
D) A throat culture for streptococcal
E) An office test for mononucleosis
- Pharyngitis is a common complaint, and usually has a viral cause.
The key factors in diagnosing streptococcal pharyngitis are:
- Fever over 100.4°F
- Tonsillar exudates
- Anterior cervical lymphadenopathy, and
- Absence of cough.
- The scenario described is consistent with a viral infection, with no
risk factors to make streptococcal infection likely; therefore, this
patient should be offered symptomatic treatment only.
- Testing for other infections is not indicated unless the patient
worsens or does not improve.
Ref: Chan TV: The patient with sore throat. Med Clin North Am