Strep throat history and symptoms

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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]

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. 1.0 1.1 http://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html Accessed on October 18, 2016
  2. 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. 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.
  4. Kids Health


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