Fever sore throat

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

Synonyms and keywords: Fever and sore throat; sore throat fever; sore throat and fever; Sore throat fever

The most important differential diagnosis for disease that cause fever and sore throat 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^[1]^[2]^[3]^[4]^[5]^[2]^[3]^[6]^[7]^[8]^[9]	Severe sore throat Otalgia Fever A "hot potato" or muffled voice Drooling Trismus	Aerobic and anaerobic bacteria Streptococcus pyogenes.	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^[10]^[11]	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 ^[12]^[13]^[14]^[15]	Sore throat Pain on swallowing Fever Headache Cough	Viral Adenovirus, Rhinovirus Influenza Coronavirus Respiratory syncytial virus. Bacterial; Group A streptococcal bacteria	Intraoral or transcutaneous USG may show an abscess making CT scan unnecessary.	Primarily affects children between 5 and 15 years old.
Diphtheria	Myocarditis Sore throat Malaise Cervical lymphadenopathy, Low-grade fever Paryngitis with or without pseudomembrane Systemic toxicity Facial paralysis to total paralysis	C. diphtheriae Rarely Corynebacterium species	X-ray: Diphtheric myocarditis: Cardiomegaly in CXR Bronchopneumonia	Diphtheria antitoxin Antibiotics may help in disease prevention

References

↑ Galioto NJ (2008). "Peritonsillar abscess". Am Fam Physician. 77 (2): 199–202. PMID 18246890.
↑ ^2.0 ^2.1 Lyon M, Blaivas M (2005). "Intraoral ultrasound in the diagnosis and treatment of suspected peritonsillar abscess in the emergency department". Acad Emerg Med. 12 (1): 85–8. doi:10.1197/j.aem.2004.08.045. PMID 15635144.
↑ ^3.0 ^3.1 Boesen T, Jensen F (1992). "Preoperative ultrasonographic verification of peritonsillar abscesses in patients with severe tonsillitis". Eur Arch Otorhinolaryngol. 249 (3): 131–3. PMID 1642863.
↑ Bandarkar AN, Adeyiga AO, Fordham MT, Preciado D, Reilly BK (2016). "Tonsil ultrasound: technical approach and spectrum of pediatric peritonsillar infections". Pediatr Radiol. 46 (7): 1059–67. doi:10.1007/s00247-015-3505-7. PMID 26637999.
↑ Scott PM, Loftus WK, Kew J, Ahuja A, Yue V, van Hasselt CA (1999). "Diagnosis of peritonsillar infections: a prospective study of ultrasound, computerized tomography and clinical diagnosis". J Laryngol Otol. 113 (3): 229–32. PMID 10435129.
↑ Brook I (2004). "Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses". J Oral Maxillofac Surg. 62 (12): 1545–50. PMID 15573356.
↑ Megalamani SB, Suria G, Manickam U, Balasubramanian D, Jothimahalingam S (2008). "Changing trends in bacteriology of peritonsillar abscess". J Laryngol Otol. 122 (9): 928–30. doi:10.1017/S0022215107001144. PMID 18039418.
↑ Snow DG, Campbell JB, Morgan DW (1991). "The microbiology of peritonsillar sepsis". J Laryngol Otol. 105 (7): 553–5. PMID 1875138.
↑ Matsuda A, Tanaka H, Kanaya T, Kamata K, Hasegawa M (2002). "Peritonsillar abscess: a study of 724 cases in Japan". Ear Nose Throat J. 81 (6): 384–9. PMID 12092281.
↑ Wick F, Ballmer PE, Haller A (2002). "Acute epiglottis in adults". Swiss Med Wkly. 132 (37–38): 541–7. PMID 12557859.
↑ Nickas BJ (2005). "A 60-year-old man with stridor, drooling, and "tripoding" following a nasal polypectomy". J Emerg Nurs. 31 (3): 234–5, quiz 321. doi:10.1016/j.jen.2004.10.015. PMID 15983574.
↑ Nogan S, Jandali D, Cipolla M, DeSilva B (2015). "The use of ultrasound imaging in evaluation of peritonsillar infections". Laryngoscope. 125 (11): 2604–7. doi:10.1002/lary.25313. PMID 25946659.
↑ Kawabata M, Umakoshi M, Makise T, Miyashita K, Harada M, Nagano H; et al. (2016). "Clinical classification of peritonsillar abscess based on CT and indications for immediate abscess tonsillectomy". Auris Nasus Larynx. 43 (2): 182–6. doi:10.1016/j.anl.2015.09.014. PMID 26527518.
↑ Fordham MT, Rock AN, Bandarkar A, Preciado D, Levy M, Cohen J; et al. (2015). "Transcervical ultrasonography in the diagnosis of pediatric peritonsillar abscess". Laryngoscope. 125 (12): 2799–804. doi:10.1002/lary.25354. PMID 25945805.
↑ Putto A (1987). "Febrile exudative tonsillitis: viral or streptococcal?". Pediatrics. 80 (1): 6–12. PMID 3601520.

[pmid18246890-1] Galioto NJ (2008). "Peritonsillar abscess". Am Fam Physician. 77 (2): 199–202. PMID 18246890.

[pmid15635144-2] 2.0 ^2.1 Lyon M, Blaivas M (2005). "Intraoral ultrasound in the diagnosis and treatment of suspected peritonsillar abscess in the emergency department". Acad Emerg Med. 12 (1): 85–8. doi:10.1197/j.aem.2004.08.045. PMID 15635144.

[pmid1642863-3] 3.0 ^3.1 Boesen T, Jensen F (1992). "Preoperative ultrasonographic verification of peritonsillar abscesses in patients with severe tonsillitis". Eur Arch Otorhinolaryngol. 249 (3): 131–3. PMID 1642863.

[pmid26637999-4] Bandarkar AN, Adeyiga AO, Fordham MT, Preciado D, Reilly BK (2016). "Tonsil ultrasound: technical approach and spectrum of pediatric peritonsillar infections". Pediatr Radiol. 46 (7): 1059–67. doi:10.1007/s00247-015-3505-7. PMID 26637999.

[pmid10435129-5] Scott PM, Loftus WK, Kew J, Ahuja A, Yue V, van Hasselt CA (1999). "Diagnosis of peritonsillar infections: a prospective study of ultrasound, computerized tomography and clinical diagnosis". J Laryngol Otol. 113 (3): 229–32. PMID 10435129.

[pmid15573356-6] Brook I (2004). "Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses". J Oral Maxillofac Surg. 62 (12): 1545–50. PMID 15573356.

[pmid18039418-7] Megalamani SB, Suria G, Manickam U, Balasubramanian D, Jothimahalingam S (2008). "Changing trends in bacteriology of peritonsillar abscess". J Laryngol Otol. 122 (9): 928–30. doi:10.1017/S0022215107001144. PMID 18039418.

[pmid1875138-8] Snow DG, Campbell JB, Morgan DW (1991). "The microbiology of peritonsillar sepsis". J Laryngol Otol. 105 (7): 553–5. PMID 1875138.

[pmid12092281-9] Matsuda A, Tanaka H, Kanaya T, Kamata K, Hasegawa M (2002). "Peritonsillar abscess: a study of 724 cases in Japan". Ear Nose Throat J. 81 (6): 384–9. PMID 12092281.

[pmid12557859-10] Wick F, Ballmer PE, Haller A (2002). "Acute epiglottis in adults". Swiss Med Wkly. 132 (37–38): 541–7. PMID 12557859.

[pmid15983574-11] Nickas BJ (2005). "A 60-year-old man with stridor, drooling, and "tripoding" following a nasal polypectomy". J Emerg Nurs. 31 (3): 234–5, quiz 321. doi:10.1016/j.jen.2004.10.015. PMID 15983574.

[pmid25946659-12] Nogan S, Jandali D, Cipolla M, DeSilva B (2015). "The use of ultrasound imaging in evaluation of peritonsillar infections". Laryngoscope. 125 (11): 2604–7. doi:10.1002/lary.25313. PMID 25946659.

[pmid26527518-13] Kawabata M, Umakoshi M, Makise T, Miyashita K, Harada M, Nagano H; et al. (2016). "Clinical classification of peritonsillar abscess based on CT and indications for immediate abscess tonsillectomy". Auris Nasus Larynx. 43 (2): 182–6. doi:10.1016/j.anl.2015.09.014. PMID 26527518.

[pmid25945805-14] Fordham MT, Rock AN, Bandarkar A, Preciado D, Levy M, Cohen J; et al. (2015). "Transcervical ultrasonography in the diagnosis of pediatric peritonsillar abscess". Laryngoscope. 125 (12): 2799–804. doi:10.1002/lary.25354. PMID 25945805.

[pmid3601520-15] Putto A (1987). "Febrile exudative tonsillitis: viral or streptococcal?". Pediatrics. 80 (1): 6–12. PMID 3601520.

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Fever sore throat

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

References

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