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.

 

 

References:

  1. Vincent MT, Celestin N, Hussain AN. Pharyngitis. Am Fam Physician. 2004 Mar 15;69(6):1465-70. [Medline]
  2. 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]
  3. 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]

Created: February 21, 2005

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