Sore Throat

• Features supporting GABHS
• Sudden onset
• Sore throat
• Fever
• Headache
• Nausea, vomiting, and abdominal pain
• Inflammation of pharynx and tonsils
• Patchy discrete exudates
• Tender, enlarged anterior cervical nodes
• Patient aged 5-15 years
• Presentation in winter or early spring
  

• Features supporting viral etiology

• Conjunctivitis
• Coryza
• Cough
• Diarrhea
  

• Centor Criteria
• 0-1 - no testing, treat sx's
• 2-3 - test and abx based on results
• 4 - no test and give abx

• Antibiotics
• Penicillin G benzathine (Bicillin L-A)
• 
  
• Penicillin G benzathine + procaine (Bicillin C-R)
• Reduced pain at injection site
• Amoxicillin

• Antibiotics (PCN Allergic)
  

• Erythromycin
• Clindamycin

• Steroids
• Single dose of steroids relieves sx's for 2-3 days

• EBV
• Age 15-24 years
  
• Test if patients have:
• Splenomegaly
• Pharyngitis > 7 days
• Abx Tx'ed sore throat without relief of sx's
• Often negative in first 1-2 weeks of sore throat
• 50% lymphocytes with at least 10% atypical lymphocytes