Bacterial Pharyngitis:
- Group A beta haemolytic streptococcal pharyngitis (GABHS) usually affects children between 5 and 15 years of age and is characterized by sudden onset of fever, sore throat with pain during swallowing.
- Examination findings include tonsillo-pharyngeal erythema and exudates, palatal petechiae, tender anterior cervical adenopathy and sometimes scarlatiniform rash. The positive predictive value of these signs for streptococcal sore throat is around 60%.
- The centor score (3 of 4 criteria) can be used to predict a bacterial etiology: exudative pharyngitis, tender cervical lymphadenopathy, fever, absence of cough.
- Confirmation of diagnosis by rapid antigen test or throat swab culture is desirable but not always possible.
- Treatment is with penicillin V/ amoxicillin is for 10 days.
- Presence of features indicative of viral etiology including coryza, conjunctivitis, cough, hoarseness, diarrhea, ulcerations and viral exanthema have high negative predictive value for GABHS pharyngitis and here diagnostic testing and antimicrobial therapy is not indicated.