Strep throat history and symptoms: Difference between revisions

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==Overview==
==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 (school, military recruit) may be suggestive of group A streptococcal pharyngitis.<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>
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.<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>


==History and Symptoms==
==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:<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>
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]]
*Nausea  
*[[Nausea]]
*Vomiting
*[[Vomiting]]
*Tender cervical lymphadenopathy
*Tender cervical [[lymphadenopathy]]
*Red and enlarged [[tonsils]]
*Red and enlarged [[tonsils]]
*Red and Black patches in the throat.
*Red and black patches in the throat
*[[Halitosis]]
*[[Halitosis]]
*Rash <ref>[http://www.kidshealth.org/parent/infections/lung/strep_throat.html Kids Health]</ref>
*[[Rash]]<ref>[http://www.kidshealth.org/parent/infections/lung/strep_throat.html Kids Health]</ref>
*Frequent cold chills
*Frequent cold chills
*Absence of cough
*Absence of [[cough]]
 
==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}}
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[[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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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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