Blog | Friday, July 20, 2018

Sore throats #thefineprint


Saying that sore throats are simple has become a trope, as thus many physicians do not seem to have a thoughtful approach to adolescent/young adult pharyngitis. As the author of the Centor Score, I would like you to consider these points when seeing sore throat patients.
1. The most important use of the score involves identifying those who need neither diagnostic tests nor antibiotics. Too many urgent cares run a group A rapid strep test on everyone with a sore throat.
2. The score is meant for acute (3 day or less) sore throat symptoms.
3. The score stratifies adolescent/young adults with bacterial pharyngitis: group A strep, group C/G strep and fusobacterium necrophorum
4. Sore throat improve over 3-5 days, if a sore throat is worsening, the patient deserves further consideration. This case report we published could help.
5. Pre-adolescents have differing severity and rarely have infections with bacteria other than GAS.

Most sore throats are simple. Our job is to recognize when the patient does not fit the usual illness script

db is the nickname for Robert M. Centor, MD, MACP. db stands both for Dr. Bob and da boss. He is an academic general internist at the University of Alabama School of Medicine, and the former Regional Dean for the Huntsville Regional Medical Campus of UASOM. He still makes inpatient rounds regularly at the Birmingham VA and Huntsville Hospital. His current titles are Professor-Emeritus and Chair-Emeritus of the ACP Board of Regents. This post originally appeared at his blog, db's Medical Rants.