GPAtlas🧭 When to suspect
Acute sore throat is among the commonest reasons for a primary care or community-pharmacy consultation. The great majority are self-limiting viral infections that settle within about a week regardless of treatment, and withholding antibiotics rarely leads to complications.
In every sore throat:
• Rationalise antibiotics using a validated score (FeverPAIN or Centor).
• Recognise the few time-critical causes (airway compromise, quinsy, sepsis).
• Never dismiss a sore throat in a vulnerable patient – especially anyone immunosuppressed or taking carbimazole, propylthiouracil, or a disease-modifying antirheumatic drug (DMARD), in whom it may herald neutropenia.
| Cause/differential | Pointers |
|---|---|
| Viral pharyngitis (commonest) | • Coryza, cough, hoarseness • Systemically well • Low FeverPAIN/Centor |
| Group A streptococcus (GAS, “strep throat”) | • Tonsillar exudate, tender anterior cervical nodes, fever, no cough • Higher FeverPAIN/Centor |
| Scarlet fever | • GAS plus a fine sandpaper rash, flushed cheeks with circumoral pallor, and strawberry tongue • Notifiable |
| Glandular fever (Epstein–Barr virus, EBV) | • Adolescents/young adults • Prolonged (> 1 week), marked posterior cervical nodes, fatigue, ± splenomegaly |
| Quinsy (peritonsillar abscess) | Severe unilateral pain, trismus, uvular deviation, “hot-potato” voice, drooling. |
| Serious/rare | • Epiglottitis/supraglottitis (rapid airway compromise) • Lemierre’s syndrome (persistent unilateral symptoms with sepsis) |
Source: NICE NG84
🔒 Sign up free to read the full topic
You're viewing a free preview. Create a free account to unlock the rest.
Sign up free →Sample topics are open to everyone in the Free Sample Bundle.