Sore Throat Flashcards
What is the most common cause of tonsillitis?
Viral
3 examples of viruses causing tonsillitis
EBV, HSV, adenovirus
What is the most common bacterial cause of tonsillitis?
Group A strep (strep pyogenes)
Centor criteria: purpose
Determines likelihood of bacterial tonsillitis (group A Strep)
4 parts of the centor criteria
- Tonsillar exudate
- Acute cervical lymphadenopathy
- Fever >38
- ABSENCE of cough
What centor score = strep infection likely?
3 or 4
5 parts of the feverPAIN score
- Fever >39
- Prurulence (exudate)
- Attend rapidly (<3 days)
- Inflamed tonsils
- No cough
For confirmed bacterial tonsillitis, what is the first line?
What would you give in penicillin allergy?
Phenoxymethylpenicillin (PEN V)
Pen allergy: clarithromycin
Which abx do you avoid in sore throat & why?
Avoid amoxicillin!! (can cause rash in EBV)
What mouthwash/ spray can be offered in tonisillitis?
Difflam mouthwash/ spray
What are the indications for referral for elective tonsillectomy?
> 7 episodes in the last year
OR >5 every year for past 2 years
What is quinsy?
AKA peritonsillar abscess
pain localised to one side of throat
Appearance of tonsils & uvula in quinsy
Bulging tonsil
Uvula displaced to one side
How is quinsy managed?
IV benzylpenicillin 1.2g (clarithromycin in allergy)
ENT referral for aspiration/ drainage
Sore throat differentials
Cold
Influenza
Glandular fever
Epiglottitis
