Strep throat history and symptoms: Difference between revisions
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==History and Symptoms== | ==History and Symptoms== | ||
The hallmark of | 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:<ref name=cdcp>http://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html Accessed on October 18, 2016</ref><ref name="pmid18245412">{{cite journal| author=Pfoh E, Wessels MR, Goldmann D, Lee GM| title=Burden and economic cost of group A streptococcal pharyngitis. | journal=Pediatrics | year= 2008 | volume= 121 | issue= 2 | pages= 229-34 | pmid=18245412 | doi=10.1542/peds.2007-0484 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18245412 }} </ref><ref name="pmid22965026">{{cite journal| author=Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G et al.| title=Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2012 | volume= 55 | issue= 10 | pages= e86-102 | pmid=22965026 | doi=10.1093/cid/cis629 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22965026 }} </ref> | ||
*High-grade [[fever]] | *High-grade [[fever]] | ||
*Difficulty swallowing | *[[Difficulty swallowing]] | ||
*[[Headache]] | *[[Headache]] | ||
*[[Abdominal pain]] | *[[Abdominal pain]] | ||
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==Centor criteria== | ==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: | |||
{| border="5" | |||
| colspan="2" align="center" |'''Modified Centor criteria''' | |||
| rowspan="9" | | |||
| colspan="3" align="center" |'''Appropriate management according to the total score''' | |||
|- | |||
| align="center" |'''Criteria''' | |||
| align="center" |'''Points''' | |||
|'''Total score''' | |||
| align="center" |'''Chance of streptococcal infection in community''' | |||
'''with usual levels of infection, %''' | |||
| align="center" |'''Suggested management''' | |||
|- | |||
| align="left" |Fever (temperature > 38°C) | |||
|align="center" | +1 | |||
|align="center" |0 | |||
|align="center" |2-3% | |||
| rowspan="2" |No culture or [[antibiotic]] is required | |||
|- | |||
| align="left" |Absence of [[cough]] | |||
|align="center" | +1 | |||
|align="center" |1 | |||
|align="center" |4-6% | |||
|- | |||
| align="left" |Swollen and tender [[lymph nodes|anterior cervical nodes]] | |||
|align="center" | +1 | |||
|align="center" |2 | |||
|align="center" |10-12% | |||
| rowspan="2" |RADT or Culture and treat only if culture result is positive | |||
|- | |||
| align="left" |[[Tonsils|Tonsillar]] swelling or [[exudate]]s | |||
|align="center" | +1 | |||
|align="center" |3 | |||
|align="center" |27-28% | |||
|- | |||
| align="left" |Age 3–14 yr | |||
|align="center" | +1 | |||
|align="center" |4 | |||
|align="center" |38–63% | |||
|Culture all and treat empirically with [[penicillin]] on clinical grounds | |||
|- | |||
| align="left" |Age 15–44 yr | |||
|align="center" |0 | |||
|- | |||
| align="left" |Age ≥ 45 yr | |||
|align="center" | -1 | |||
|- | |||
|} | |||
==References== | ==References== | ||
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{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Emergency mdicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Pediatrics]] | |||
[[Category:Otolaryngology]] | |||
Latest revision as of 00:18, 30 July 2020
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Strep throat Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Strep throat history and symptoms On the Web |
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American Roentgen Ray Society Images of Strep throat history and symptoms |
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Risk calculators and risk factors for 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