Which clinical history findings are characteristic of pediatric pharyngitis?

Updated: Dec 11, 2018
  • Author: Harold K Simon, MD, MBA; Chief Editor: Russell W Steele, MD  more...
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Clinical differentiation of the various pathogens of pharyngitis on the basis of history or physical examination is difficult. As Feinstein et al noted in 1962, “[t]he only typical feature of streptococcal infections is the failure to show a single, consistent, typical feature.”

A history of exposure to known carriers, fever, headache, and abdominal pain in conjunction with sore throat suggests group A beta-hemolytic streptococcal (GABHS) pharyngitis. Involvement of other mucous membranes (eg, conjunctivitis, coryza) suggests a viral etiology. Age may also dictate the level of concern because GABHS is rarely a true rheumatogenic pathogen in children younger than 2 years.

Because supportive care is a primary goal in all cases, historical information regarding oral intake and hydration status is important. Obtain information about previous treatments, treatment failures, and medication allergies.

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