In this post, I link to and excerpt from Enter The Centor, [about sore throat and strep throat] by Taming The SRU, September 08, 2019.
All that follows is from the above resource.
QUICK HITS [Summary of the post]
When evaluating a patient with sore throat, consider alternatives to group A streptococcal pharyngitis. Mimics include acute HIV, gonococcal pharyngitis, and infectious mononucleosis.
The modified Centor score uses 5 factors to help guide clinical decision making:
Fever
Tonsillar exudate
Absent cough
Anterior cervical lymphadenopathy
Age
Low modified Centor scores do not require further testing or treatment in the general population
Mid range Centor scores require rapid antigen detection testing (RADT)
High modified Centor scores can undergo RADT or empiric treatment according to some guidelines, however, there is concern that empiric treatment may lead to antibiotic overuse.
Treatment with penicillin V or amoxicillin is preferred, in the penicillin allergic patient, first generation cephalosporins or a macrolide can be used.
