Sore throat - Revision history

Danbot: Strip excess bold

2026-03-22T09:35:06Z

Strip excess bold

← Older revision		Revision as of 09:35, 22 March 2026
Line 2:		Line 2:
	*Sore throat is one of the most common chief complaints in the ED and primary care		*Sore throat is one of the most common chief complaints in the ED and primary care
	*Most cases are viral and self-limited		*Most cases are viral and self-limited
	*The primary ED goals are to identify ~~'''~~dangerous causes~~'''~~ (peritonsillar abscess, retropharyngeal abscess, epiglottitis, Ludwig's angina) and appropriately test/treat for Group A Strep		*The primary ED goals are to identify dangerous causes (peritonsillar abscess, retropharyngeal abscess, epiglottitis, Ludwig's angina) and appropriately test/treat for Group A Strep
	[[File:Gray1014.png\|thumb\|Anatomy of the posterior pharynx.]]		[[File:Gray1014.png\|thumb\|Anatomy of the posterior pharynx.]]
	[[File:Infrahyoid deep neck spaces.png\|thumb\|Infrahyoid deep neck spaces]]		[[File:Infrahyoid deep neck spaces.png\|thumb\|Infrahyoid deep neck spaces]]
Line 37:		Line 37:

	==Evaluation==		==Evaluation==
	*~~'''~~Centor criteria~~'''~~ (modified/McIsaac) to guide Group A Strep testing:<ref>McIsaac WJ, et al. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ. 1998;158(1):75-83.</ref>		*Centor criteria (modified/McIsaac) to guide Group A Strep testing:<ref>McIsaac WJ, et al. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ. 1998;158(1):75-83.</ref>
	**Tonsillar exudates (+1)		**Tonsillar exudates (+1)
	**Tender anterior cervical lymphadenopathy (+1)		**Tender anterior cervical lymphadenopathy (+1)
Line 43:		Line 43:
	**Absence of cough (+1)		**Absence of cough (+1)
	**Age 3-14 (+1), Age 15-44 (0), Age ≥45 (-1)		**Age 3-14 (+1), Age 15-44 (0), Age ≥45 (-1)
	*~~'''~~Score ≤1:~~'''~~ No testing needed; unlikely GAS		*Score ≤1: No testing needed; unlikely GAS
	*~~'''~~Score 2-3:~~'''~~ Rapid strep test; treat if positive		*Score 2-3: Rapid strep test; treat if positive
	*~~'''~~Score ≥4:~~'''~~ Rapid strep test (or empiric treatment); treat if positive		*Score ≥4: Rapid strep test (or empiric treatment); treat if positive
	*~~'''~~CT neck with IV contrast~~'''~~ if deep space infection suspected (peritonsillar abscess, retropharyngeal abscess, Ludwig's angina)		*CT neck with IV contrast if deep space infection suspected (peritonsillar abscess, retropharyngeal abscess, Ludwig's angina)
	*Consider [[monospot]] or [[EBV]] testing if infectious mononucleosis suspected (especially adolescents/young adults with prolonged symptoms, significant lymphadenopathy, hepatosplenomegaly)		*Consider [[monospot]] or [[EBV]] testing if infectious mononucleosis suspected (especially adolescents/young adults with prolonged symptoms, significant lymphadenopathy, hepatosplenomegaly)
	*[[Lateral soft tissue neck X-ray]] — if [[epiglottitis]] or [[retropharyngeal abscess]] suspected (prevertebral soft tissue widening)		*[[Lateral soft tissue neck X-ray]] — if [[epiglottitis]] or [[retropharyngeal abscess]] suspected (prevertebral soft tissue widening)
Line 52:		Line 52:

	==Management==		==Management==
	*~~'''~~Most sore throats are viral~~'''~~ → supportive care:		*Most sore throats are viral → supportive care:
	**NSAIDs and/or acetaminophen for pain		**NSAIDs and/or acetaminophen for pain
	**Encourage PO fluids		**Encourage PO fluids
	**Warm salt water gargles, throat lozenges		**Warm salt water gargles, throat lozenges
	*~~'''~~Group A Strep pharyngitis:~~'''~~		*Group A Strep pharyngitis:
	**[[Penicillin V]] or [[amoxicillin]] x 10 days (first line)		**[[Penicillin V]] or [[amoxicillin]] x 10 days (first line)
	**[[Azithromycin]] if penicillin allergic		**[[Azithromycin]] if penicillin allergic
	**See [[Streptococcal pharyngitis]]		**See [[Streptococcal pharyngitis]]
	*~~'''~~[[Peritonsillar abscess]]:~~'''~~		*[[Peritonsillar abscess]]:
	**Needle aspiration or incision and drainage		**Needle aspiration or incision and drainage
	**Antibiotics (see [[PTA]])		**Antibiotics (see [[PTA]])
	*~~'''~~[[Epiglottitis]]:~~'''~~		*[[Epiglottitis]]:
	**Emergent airway management, avoid agitating patient		**Emergent airway management, avoid agitating patient
	**IV antibiotics (see [[Epiglottitis]])		**IV antibiotics (see [[Epiglottitis]])
	*~~'''~~[[Ludwig's angina]]:~~'''~~		*[[Ludwig's angina]]:
	**Emergent airway management		**Emergent airway management
	**IV antibiotics, surgical consultation		**IV antibiotics, surgical consultation
	*~~'''~~Dexamethasone~~'''~~ single dose (10 mg IV or 0.6 mg/kg PO) may reduce pain in moderate-severe pharyngitis<ref>Hayward G, et al. Corticosteroids for the common cold. Cochrane Database Syst Rev. 2015;(10):CD008116.</ref>		*Dexamethasone single dose (10 mg IV or 0.6 mg/kg PO) may reduce pain in moderate-severe pharyngitis<ref>Hayward G, et al. Corticosteroids for the common cold. Cochrane Database Syst Rev. 2015;(10):CD008116.</ref>

	==Disposition==		==Disposition==
	*~~'''~~Admit:~~'''~~		*Admit:
	**Peritonsillar abscess (if unable to tolerate PO after drainage, or bilateral/complicated)		**Peritonsillar abscess (if unable to tolerate PO after drainage, or bilateral/complicated)
	**Retropharyngeal abscess		**Retropharyngeal abscess
Line 79:		Line 79:
	**Airway compromise		**Airway compromise
	**Severe dehydration		**Severe dehydration
	*~~'''~~Discharge with follow-up:~~'''~~		*Discharge with follow-up:
	**Viral pharyngitis		**Viral pharyngitis
	**Strep pharyngitis with appropriate antibiotics		**Strep pharyngitis with appropriate antibiotics

Danbot: Comprehensive expansion: EM-focused approach with red flags, Centor criteria, evaluation strategy, and management by diagnosis

2026-03-20T22:57:39Z

Comprehensive expansion: EM-focused approach with red flags, Centor criteria, evaluation strategy, and management by diagnosis

@@ Line 1: / Line 1: @@
 ==Background==
 [[File:Gray1014.png|thumb|Anatomy of the posterior pharynx.]]
 [[File:Infrahyoid deep neck spaces.png|thumb|Infrahyoid deep neck spaces]]
 ==Clinical Features==
 ==Differential Diagnosis==
@@ Line 13: / Line 28: @@
 *[[GERD]]
 *Obstructive sleep apnea
-*[[Fungal infections]] (ex. [[candida]])
+*[[Fungal infections]] (e.g., [[Candidiasis|candida]])
-*Chronic [[sinusitis]] with post nasal drip
+*Chronic [[sinusitis]] with post-nasal drip
 *Inhalation of irritants (smoke, [[chlorine gas]])
 *Glossopharyngeal neuralgia
-*Tumor:
+*Tumor (tongue, larynx, thyroid)
 *[[Thyroiditis]]
-*[[Esophageal Foreign Body|Retained Foreign Body]]
+*[[Esophageal foreign body|Retained foreign body]]
 ==Evaluation==
 ==Management==
 ==Disposition==
 ==See Also==
 *[[Pharyngitis]]
-*[[Strep Pharyngitis]]
+*[[Streptococcal pharyngitis]]
 *[[Neck mass]]
 ==External Links==

Rossdonaldson1 at 21:57, 13 November 2024

2024-11-13T21:57:56Z

← Older revision		Revision as of 21:57, 13 November 2024
Line 1:		Line 1:
			==Background==
	[[File:Gray1014.png\|thumb\|Anatomy of the posterior pharynx.]]		[[File:Gray1014.png\|thumb\|Anatomy of the posterior pharynx.]]
			[[File:Infrahyoid deep neck spaces.png\|thumb\|Infrahyoid deep neck spaces]]
			[[File:EB1911 - Tongue.png\|thumb\|Neck anatomy at the level of the tongue.]]
			[[File:Human anatomy, including structure and development and practical considerations (1911) (14594049867).jpg\|thumb\|Midline neck anatomy on lateral view.]]

			==Clinical Features==

	==Differential Diagnosis==		==Differential Diagnosis==
	{{Sore throat DDX}}		{{Sore throat DDX}}
Line 18:		Line 25:
	*[[Thyroiditis]]		*[[Thyroiditis]]
	*[[Esophageal Foreign Body\|Retained Foreign Body]]		*[[Esophageal Foreign Body\|Retained Foreign Body]]

			==Evaluation==

			==Management==

			==Disposition==

	==See Also==		==See Also==
Line 24:		Line 37:
	*[[Neck mass]]		*[[Neck mass]]
	*[[Uvulitis]]		*[[Uvulitis]]

			==External Links==

	==References==		==References==

Rossdonaldson1 at 05:25, 6 January 2022

2022-01-06T05:25:44Z

← Older revision		Revision as of 05:25, 6 January 2022
Line 1:		Line 1:
			[[File:Gray1014.png\|thumb\|Anatomy of the posterior pharynx.]]
	==Differential Diagnosis==		==Differential Diagnosis==
	{{Sore throat DDX}}		{{Sore throat DDX}}

ClaireLewis at 22:37, 30 September 2019

2019-09-30T22:37:32Z

← Older revision		Revision as of 22:37, 30 September 2019
Line 4:		Line 4:
	===Chronic Sore Throat===		===Chronic Sore Throat===
	*[[GERD]]		*[[GERD]]
	*~~obstructive~~ sleep apnea		*Obstructive sleep apnea
	*~~fungal~~ infections (ex. candida)		*[[Fungal infections]] (ex. [[candida]])
	*~~chronic~~ [[sinusitis]] with post nasal drip		*Chronic [[sinusitis]] with post nasal drip
	*~~inhalation~~ of irritants (smoke, chlorine gas)		*Inhalation of irritants (smoke, [[chlorine gas]])
	*~~breathing~~ dry air		*Breathing dry air
	*~~glossopharyngeal~~ neuralgia		*Glossopharyngeal neuralgia
	*Tumor:		*Tumor:
	**Tongue		**Tongue
	**Larynx		**Larynx
	**Thyroid		**Thyroid
	*~~monomyelocytic~~ leukemia		*Monomyelocytic [[leukemia]]
	*[[Thyroiditis]]		*[[Thyroiditis]]
	*[[Esophageal Foreign Body\|Retained Foreign Body]]		*[[Esophageal Foreign Body\|Retained Foreign Body]]

Rossdonaldson1: /* See Also */

2019-08-17T21:19:08Z

Rossdonaldson1: /* References */

2019-08-17T21:18:32Z

References

← Older revision		Revision as of 21:18, 17 August 2019
Line 25:		Line 25:
	==References==		==References==
	<references/>		<references/>
	~~Harwood-Nuss, Tintinalli~~

	[[Category:ENT]]		[[Category:ENT]]
	[[Category:Symptoms]]		[[Category:Symptoms]]

Zipdoc: crosslink

2016-12-13T19:47:46Z

crosslink

← Older revision		Revision as of 19:47, 13 December 2016
Line 21:		Line 21:
	*[[Strep Pharyngitis]]		*[[Strep Pharyngitis]]
	*[[Neck mass]]		*[[Neck mass]]
			*[[Uvulitis]]

	==References==		==References==

ClaireLewis: /* References */

2016-10-29T17:10:39Z

References

← Older revision		Revision as of 17:10, 29 October 2016
Line 27:		Line 27:

	[[Category:ENT]]		[[Category:ENT]]
			[[Category:Symptoms]]

Rossdonaldson1: /* See Also */

2016-08-15T02:35:51Z

← Older revision		Revision as of 21:19, 17 August 2019
Line 19:		Line 19:

	==See Also==		==See Also==
			*[[Pharyngitis]]
	*[[Strep Pharyngitis]]		*[[Strep Pharyngitis]]
	*[[Neck mass]]		*[[Neck mass]]

← Older revision		Revision as of 02:35, 15 August 2016
Line 19:		Line 19:

	==See Also==		==See Also==
	[[Strep Pharyngitis]]		*[[Strep Pharyngitis]]
			*[[Neck mass]]

	==References==		==References==