An approach to diagnosing the acute sore throat.
Sore throat is a common presenting complaint. Although patients often are concerned that they may have group A beta-hemolytic streptococcal (GABHS) pharyngitis, most sore throats are not caused by this infection. A number of illnesses and conditions present as sore throat. After life-threatening conditions are excluded, efforts to identify and treat patients with GABHS pharyngitis are appropriate. Efforts should include a directed history and physical examination, looking for exudative pharyngitis with fever, adenopathy and lack of cough or other respiratory symptoms. These findings predict a positive GABHS culture rate of 50 percent or more. The rapid Streptococcus test has a high positive predictive value, but it has a lower sensitivity rate. Treatment strategies for patients with sore throat are based on epidemiologic factors, signs and symptoms, and results of laboratory tests.
Perkins
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Department of Family Practice, University of South Alabama College of Medicine, Mobile 36604, USA.
D000208:Acute Disease; D000465:Algorithms; D019411:Clinical Laboratory Techniques; D003937:Diagnosis, Differential; D006801:Humans; D008487:Medical History Taking; D010612:Pharyngitis / Q000150:complications / Q000175:diagnosis* / Q000209:etiology* / Q000382:microbiology* / Q000628:therapy; D010808:Physical Examination; D013290:Streptococcal Infections / Q000175:diagnosis / Q000382:microbiology