My developing thoughts on adult pharyngitis

MDCalc invited me to write a blog post about pharyngitis (they had previously asked me to comment on the Centor score). That post includes much of my current thinking – Sometimes it’s NOT just a sore throat – adolescents and young adults are different The other important concept that I did not include in that post came up in a conversation I had yesterday at the University of Nebraska where I am this week as a visiting professor.  A clinician educator asked me about “red flags” in sore throat patients.  While I have written this previously, repetition helps all learners remember. Adult sore throats generally last around 3-5 days.  The patient no longer has a routine sore throat when: It continues feeling worse – most Lemierre syndrome patients complain that they precedent sore throat was the worst they ever had The patient develops rigors – Lemierre included this in his classic article, and we have found this in our clinical experience.  Lemierre syndrome patients have bacteremia and the body responds with rigors (and somewhat less often drenching sweats) Unilateral neck swelling – requires imaging looking for either peritonsillar abscess or internal jugular suppurative thrombophlebitis. Most sore throats are totally benign – either with or without antibiotic treatment.  But, our job is to be aware of the unusual presentations of a common complaint.  I hope these clues stay in your memory and triggers concern and further e...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs