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:
- 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]
Created: Feb 21, 2005
