Which physical findings suggest a diagnosis of viral pediatric pharyngitis?

Updated: Dec 11, 2018
  • Author: Harold K Simon, MD, MBA; Chief Editor: Russell W Steele, MD  more...
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Viral pharyngitis is usually associated with sneezing, rhinorrhea, and cough. For example, H1N1 influenza can present with sore throat but may also have other associated symptoms (eg, rhinorrhea and cough). Mononucleosis is typically exudative with extensive false membranes. Herpangina (usually coxsackievirus A) is associated with papulovesicular lesions of the skin (ie, hand-foot-and-mouth disease). Diphtheria (rare in developed countries) is associated with a thick gray membrane that is difficult to remove, is highly friable, and bleeds if manipulated.

It is important to look for tonsillar asymmetry, which may be a sign of peritonsillar abscesses. This condition can occur in conjunction with soft palate bulging and deviation of the uvula. Pay particular attention to signs of dehydration because supportive care is a primary concern and essential regardless of the etiologic agent.

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