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. 2014 Oct 31:753–759.e2. doi: 10.1016/B978-1-4557-4801-3.00059-X

TABLE 59-2.

Clinical and Epidemiologic Findings Associated with Group A Streptococcus Pharyngitis

Suggestive of Group A Streptococcus

  • Sudden onset

  • Sore throat

  • Fever

  • Headache

  • Nausea, vomiting, and abdominal pain

  • Inflammation of pharynx and tonsils

  • Patchy discrete exudates

  • Tender, enlarged anterior cervical nodes

  • Patient aged 5-15 yr

  • Presentation in winter or early spring

  • History of exposure

Suggestive of Viral Etiology

  • Conjunctivitis

  • Coryza

  • Cough

  • Diarrhea

  • Discrete ulcerative lesions

Suggestive of Complications of Pharyngitis

  • Dysphagia

  • Stridor

  • Drooling

  • Dysphonia

  • Marked neck swelling

  • Respiratory distress

  • Pharyngeal pseudomembrane

  • Hemodynamic instability

  • HIV behavioral risk

  • Travel to or exposure to individuals from a region endemic for diphtheria

  • Lack of diphtheria immunization

HIV, human immunodeficiency virus.

Modified from Shulman ST, Bisno AL, Clegg HW, et al. 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. 2012;55:e86-e102; and Kociolek LK, Shulman ST. In the clinic. Pharyngitis. Ann Intern Med. 2012;157:ITC3-1-ITC3-16; with permission.