Featured

  Enter the Centor

When evaluating a patient with sore throat, consider alternatives to group A streptococcal pharyngitis. Mimics include acute HIV, gonococcal pharyngitis, and infectious mononucleosis.

 Corticosteroids in Pharyngitis – Systematic Review + Meta-Analysis

In cases of severe pharyngitis, single low dose corticosteroid administration would likely provide symptomatic benefit that outweigh potential adverse effects.

 Not All Sore Throats Are Pharyngitis

The importance of this case is to recognize that not every sore throat is simply pharyngitis. Other causes should be included in the differential.

 Simplifying pharyngitis management

Bottom line: Amoxicillin 50 mg/kg once daily (max 1000 mg daily) is an acceptable alternative to multiple daily doses of penicillin or amoxicillin for treatment of Group-A streptococcal pharyngitis infections.

Articles of Interest

Sore Throats—What Really Works?

Sore throat is a common complaint in the emergency department and outpatient clinic setting. “Strep throat” caused by Streptococcus pyogenes accounts for just 5%-15% of all adult pharyngitis and tonsillitis. Most cases are caused by viruses, yet more than 75% of adult patients receive antibiotics.

Do Patients with Strep Throat Need to Be Treated with Antibiotics?

We are far more likely to harm patients with strep pharyngitis by giving antibiotics than to help them in developed countries. This does not apply to developing countries with poor public health.

Evidence-Based Evaluation And Management Of Patients With Pharyngitis In The Emergency Department

Pharyngitis is a common presentation, but it can also be associated with life-threatening processes, including sepsis and airway compromise. Other conditions, such as thyroid disease and cardiac disease, may mimic pharyngitis.

Pediatric Pharyngitis

After potentially serious\life-threatening diseases are excluded, the main treatment decisions are to determine the likelihood of GAS pharyngitis and if antibiotics are indicated.

Strep Throat Mimics: Pearls & Pitfalls

The majority of cases of acute pharyngitis are caused by viral illnesses. The three most common viral agents are rhinovirus, coronavirus, and adenovirus, but there are several others as discussed below. Symptoms of cough, conjunctivitis, coryza, and diarrhea are more common with viral pharyngitis than with bacterial causes of pharyngitis.

Resources

WikEM

Exudates do not mean bacterial- most common cause of exudative pharyngitis is still viral.