Pharyngitis
Essentials of Diagnosis Abrupt onset of sore throat, fever, malaise, nausea, andheadache. Throat red and edematous, with or without exudate; cervicalnodes tender. Diagnosis confirmed by culture of throat. General Considerations Group A beta-hemolytic streptococci (Streptococcus pyogenes) are the most common bacterial cause of pharyngitis. Transmission occurs by droplets of infected secretions. Group A streptococci producing erythrogenic toxin may cause scarlet fever in susceptible persons. Clinical Findings SYMPTOMS AND SIGNS "Strep throat" is characterized by a sudden onset of fever, sore throat, pain on swallowing, tender cervical adenopathy, malaise, and nausea. The pharynx, soft palate, and tonsils are red and edematous. There may be a purulent exudate. The Centor clinical criteria for the diagnosis of streptococcal pharyngitis are temperature > 38 °C, tender anterior cervical adenopathy, lack of a cough, and pharyngotonsillar exudate. The rash of scarlet fever is dif...