What are the classic presentations of pharyngitis (sore throat)?

Updated: May 06, 2020
  • Author: John R Acerra, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Viral and bacterial causes of pharyngitis are similar, and the differentiation of the etiology is difficult based on history and physical examination alone. Signs and symptoms alone cannot be used to rule out or diagnose GAS pharyngitis. [11] Despite this, classic presentations are described below.

  • GAS infection is most common in children aged 4-7 years.

  • Sudden onset is consistent with a GAS pharyngitis. Pharyngitis following several days of coughing or rhinorrhea is more consistent with a viral etiology.

  • Person has been in contact with others diagnosed with GAS or rheumatic fever presenting with symptoms consistent with GAS are more likely to have GAS pharyngitis.

  • Headache is consistent with GAS infection.

  • Cough is not usually associated with GAS infection.

  • Vomiting is associated with GAS infection but may be present in other types of pharyngitis.

  • A history of recent orogenital contact suggests the possibility of gonococcal pharyngitis.

  • A history of rheumatic fever is important when considering treatment.

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