Fever sore throat

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]

The most important differential diagnosis for disease that cause fever and sorethroat at the same time are summarized in table below:

Disease/Variable	Presentation	Causes	Imaging finding	Treatment
Upper respiratory tract infection	Itchy, watery eyes Nasal discharge Nasal congestion Sneezing Sore throat Cough Headache Fever Malaise Fatigue, weakness Muscle pain	Influenza viruses	_	Symptomatic therapy: Decongestants Alternative medicine The use of Vitamin C
Peritonsillar abscess	Severe sore throat Otalgia Fever A "hot potato" or muffled voice Drooling Trismus	Aerobic and anaerobic bacteria Streptococcuspyogenes.	On ultrasound peritonsillar abscess appears as focal irregularly marginated hypoechoic area.	Ampicillin-sulbactam, Clindamycin, Vancomycin or Linezolid
Croup	cough stridor but no drooling Hoarseness Difficulty breathing common cold Runny nose Fever	Parainfluenza virus	Steeple sign on neck X-ray	Dexamethasone and nebulised epinephrine
Epiglottitis	Stridor and drooling but no cough Difficulty breathing Fever Chills Difficulty swallowing Hoarseness of voice	H. influenza type b Beta-hemolytic streptococci Staphylococcus aureus fungi viruses.	Thumbprint sign on neck x-ray	Airway maintenance, parenteral Cefotaxime or Ceftriaxone in combination with Vancomycin. Adjuvant therapy includes corticosteroids and racemic Epinephrine.
Pharyngitis	Sore throat Pain on swallowing Fever Headache Abdominal pain Nausea and vomiting	Group A beta-hemolytic streptococcus	_	Antimicrobial therapy mainly penicillin-based and analgesics.
Tonsilitis	Sore throat Pain on swallowing Fever Headache Cough	Viral Adenovirus, Rhinovirus Influenza Coronavirus Respiratory syncytial virus. Bacterial; Group A streptococcalbacteria	Intraoral or transcutaneous USG may show an abscess making CT scan unnecessary.	Primarily affects children between 5 and 15 years old.
Sinusitis	Nasal congestion and blockage Facial pain and pressure Ear pressure or fullness Nasal discharge, which may be purulent Decreased or absent sense of smell Headache Cough Fever Fatigue Bad breath Maxillary tooth pain	Viruses Rhinovirus Influenza virus Parainfluenza virus Bacteria Streptococcus pneumoniae Haemophilus influenzae Moraxella catarrhalis Streptococcus pyogenes Staphylococcus aureus: common in chronic sinusitis Pseudomonas aeruginosa	On CT scan, a mass impinging on the posterior pharyngeal wall with rim enhancement is seen	Supportive therapy is the mainstay of treatment for both cases of acute and chronic rhinosinusitis. Antibioticsc(macrolides, penicillins, clavulonic acid- amoxicillin)an be added in select cases of acute, as well as chronicrhinosinusitis.