Clinical QuickieInfectious Disease
Pharyngitis
The exam can estimate probability; testing confirms who benefits from antibiotics.
Separate viral clues from GAS probability
Cough, rhinorrhea, hoarseness, oral ulcers, and conjunctivitis favor viral disease; fever, tender anterior cervical nodes, tonsillar exudate, and absence of cough raise GAS probability.
Use a validated testing pathway
Clinical scores help decide who needs testing; they are not a substitute for microbiologic confirmation when confirmation is recommended.
Antibiotics have a narrow target
Treat confirmed group A streptococcal infection according to the appropriate pathway; do not treat viral pharyngitis.
Watch for alternate serious causes
Peritonsillar abscess, epiglottitis, deep-neck infection, mononucleosis, gonococcal infection, and airway compromise require different evaluation.
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