Strep throat history and symptoms
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]
Overview
The hallmark of strep throat is the sudden onset of sore throat and high-grade fever with the absence of cough. A positive history of ill contact with strep throat and overcrowding (e.g., school, military recruit) may be suggestive of group A streptococcal pharyngitis.[1][2][3]
History and Symptoms
The hallmark of strep throat is sudden onset of sore throat. A positive history of ill contact with strep throat and overcrowding (school, military recruit) may be suggestive of group A streptococcal pharyngitis. The most common symptoms of strep throat include:[1][2][3]
- High-grade fever
- Difficulty swallowing
- Headache
- Abdominal pain
- Nausea
- Vomiting
- Tender cervical lymphadenopathy
- Red and enlarged tonsils
- Red and black patches in the throat
- Halitosis
- Rash[4]
- Frequent cold chills
- Absence of cough
Centor criteria
The Centor criteria determines the likelihood of a patient having a strep throat infection based on various history and physical examination findings, as follows:
| Modified Centor criteria | Appropriate management according to the total score | ||||
| Criteria | Points | Total score | Chance of streptococcal infection in community
with usual levels of infection, % |
Suggested management | |
| Fever (temperature > 38°C) | +1 | 0 | 2-3% | No culture or antibiotic is required | |
| Absence of cough | +1 | 1 | 4-6% | ||
| Swollen and tender anterior cervical nodes | +1 | 2 | 10-12% | RADT or Culture and treat only if culture result is positive | |
| Tonsillar swelling or exudates | +1 | 3 | 27-28% | ||
| Age 3–14 yr | +1 | 4 | 38–63% | Culture all and treat empirically with penicillin on clinical grounds | |
| Age 15–44 yr | 0 | ||||
| Age ≥ 45 yr | -1 | ||||
References
- ↑ 1.0 1.1 http://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html Accessed on October 18, 2016
- ↑ 2.0 2.1 Pfoh E, Wessels MR, Goldmann D, Lee GM (2008). “Burden and economic cost of group A streptococcal pharyngitis”. Pediatrics. 121 (2): 229–34. doi:10.1542/peds.2007-0484. PMID 18245412.
- ↑ 3.0 3.1 Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G; et al. (2012). “Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America”. Clin Infect Dis. 55 (10): e86–102. doi:10.1093/cid/cis629. PMID 22965026.
- ↑ Kids Health
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