Sore throat is a common medical complaint seen by the emergency practitioner, internist, pediatrician, and otolaryngologist. The differential for sore throat is vast. However, with a directed history this can often be narrowed down to 2 to 3 possible diagnoses. By paying particular attention to the associated symptoms and duration of symptoms, common self-limited etiologies like viral pharyngitis and nonstreptococcal tonsillitis can be distinguished from those that require more investigation, such as supraglottitis and tonsillar cancer. A sore throat is most commonly caused by an infectious, inflammatory, or neoplastic etiologic factor.

Infectious mononucleosis ("mono") is an infection that causes sore throat, fever, swollen glands, and tiredness or fatigue. Causes of Infectious MononucleosisInfectious mononucleosis is transmitted by exposure to saliva, so it can be spread by kissing, by sharing glasses or cutlery, and by droplets spread by coughing.Mono is usually caused by the Epstein-Barr virus.It most often affects children, teenagers, and young adults.Other diseases that cause similar symptoms include infection with other viruses that cause sore throat, streptococcal bacteria ("strep throat"), or cytomegalovirus.

contact with skin infected with group A strep. The diagnosis is made based on the results of a rapid antigen detection test or throat culture. Some people may Streptococcal pharyngitis, also known as streptococcal sore throat (strep throat), is pharyngitis (an infection of the pharynx, the back of the throat) caused by Streptococcus pyogenes, a gram-positive, group A streptococcus. Common symptoms include fever, sore throat, red tonsils, and enlarged lymph nodes in the front of the neck. A headache and nausea or vomiting may also occur. Some develop a Streptoco… As the symptoms of streptococcal pharyngitis overlap with other conditions, it can be difficult to make the diagnosis clinically. Coughing, nasal discharge, diarrhea, and red, irritated eyes in addition to fever and sore throat are more indicative of a viral sore throat than of strep throat. The presence of marked lymph node enlargement along with sore throat, fever, and tonsillar enlargement may also occur in infectious mononucleosis. Other conditions that may present similarly include epiglottitis, Kawasaki disease, acute retroviral syndrome, Lemierre's syndrome, Ludwig's angina, peritonsillar abscess, and retropharyngeal abscess.

[Evaluation of a rapid technique for detecting the type A Streptococcus antigen (Test Pack Strep A)]. To test a rapid technique of Antigen Detection (TAD) of Type A Betahemolitic Streptococci (BHSA) in Acute Tonsillitis (AT), comparing it with and using as a point of reference traditional Blood Agar Cultivation (BAC). Additionally, the use of Clinical Data as a method of supposed Diagnosis was studied. Prospective observational study. SITE. Health Primary Care (Maspalomas Health Centre). 118 patients between the ages of 1 and 71 affected by AT. There was a proportion of 13.56% BHSA in the AT of our sample, with a Confidence Interval (CI) of 95% (7.38-19.74) using the BAC; and 17.80% with a CI of 95% (10.90-24.70) using the TAD. The following values were obtained for the TAD: Sensitivity (S) of 93.75%, Specificity (Sp) of 94.12%, Positive Predictive Value (PPV) of 71.43% and Negative Predictive Value (NPV) of 98.9%. Of the clinical variables studied, only the presence/absence of Exudate and Adenopathies were linked to the presence of BHSA in the Cultivations (p less than 0.05 and p less than 0.01 respectively); with, however, inconclusive S, Sp, PPV and PNV values.

Adult and pediatric pharyngitis: a review. Acute pharyngitis is frequently encountered in the ambulatory care setting. Although usually of viral etiology, streptococcal disease is the focus of diagnostic efforts, in light of significant suppurative and nonsuppurative sequelae. The traditional symptoms of fever, adenopathy, and pharyngeal exudate are suggestive, but not diagnostic of streptococcal pharyngitis. Thus, the importance of diagnostic testing, including Group A beta hemolytic strep antigen screen and culture, is emphasized. Recent innovations in therapy include modification of antibiotic dosing regimens and use of cephalosporins to improve patient compliance. Published in The Journal of emergency medicine

The diagnosis of strep throat in adults in the emergency room. Adult patients who presented to an urban emergency room complaining of a sore throat had cultures and clinical information recorded. Models were constructed, using logistic regression analysis, of both a positive culture for Group A beta streptococcus and a positive guess by a resident. The model of a positive culture consisted of four variables--tonsillar exudates, swollen tender anterior cervical nodes, lack of a cough, and history of fever. Patients with all 4 variables had a 56% probability of a positive culture; 3 variables, 32%; 2 variables, 15%; 1 variable, 6.5%; and 0 variables, 2.5%. The model of a positive guess by a resident demonstrated an over-reliance on physical exam and an underuse of history. The model of a positive culture allows stratification of patients to assist clinicians in the management strategies. Published in Medical decision making : an international journal of the Society for Medical Decision Making (1981)

of the disease is often pharyngitis, which is frequently accompanied by enlarged tonsils with pus—an exudate similar to that seen in cases of strep throat Infectious mononucleosis (IM, mono), also known as glandular fever, is an infection usually caused by the Epstein–Barr virus (EBV). Most people are infected by the virus as children, when the disease produces few or no symptoms. In young adults, the disease often results in fever, sore throat, enlarged lymph nodes in the neck, and fatigue. Most people recover in two to four weeks; however, fatigue Fever – usually lasting 14 days; often mild. Sore throat – usually severe for 3–5 days, before resolving in the next 7–10 days. Swollen glands – mobile; usually located around the back of the neck (posterior cervical lymph nodes) and sometimes throughout the body. Another major symptom is feeling tired. Headaches are common, and abdominal pains with nausea or vomiting sometimes also occur. Symptoms most often disappear after about 2–4 weeks. However, fatigue and a general feeling of being unwell (malaise) may sometimes last for months. Fatigue lasts more than one month in an estimated 28% of cases. Mild fever, swollen neck glands and body aches may also persist beyond 4 weeks. Most people can resume their usual activities within 2–3 months. The most prominent sign of the disease is often pharyngitis, which is frequently accompanied by enlarged tonsils with pus—an exudate similar to that seen in cases of strep throat. In about 50% of cases, small reddish-purple spots called petechiae can be seen on the roof of the mouth. Palatal enanthem can also occur, but is relatively uncommon. A small minority of people spontaneously present a rash, usually on the arms or trunk, which can be macular (morbilliform) or papular. Almost all people given amoxicillin or ampicillin eventually develop a generalized, itchy maculopapular rash, which however does not imply that the person will have adverse reactions to penicillins again in the future. Occasional cases of erythema nodosum and erythema multiforme have been reported. Seizures may also…