When should sore throats be referred to the hospital?
Stridor or respiratory difficulty is an emergency
Suspicion of throat cancer (persistent sore throat, esp. with neck mass)
Lasting for >3-4 weeks
Pain on swallowing or dysphagia for >3 weeks
Red/red-white/ulceration/ swelling of the oral or pharyngeal mucosa persists for >3 weeks
Causes of a sore throat?
Acute pharyngitis - inflammation of oropharynx
OR
Tonsillitis - inflammation of the tonsils
Either with viral or bacterial infection; non-infectious causes (e.g: GORD, smoking, alcohol, hayfever) are uncommon
Occurrence of sore throats?
Common at any age but part. in children of 5-10 years and in young adults of 15-25 years
Complications of sore throat?
Otitis media (most commonly)
Peri-tonsillar abscess (quinsy)
Parapharyngeal abscess
Mastoiditis
Treatment of sore throats?
Resolve within 3 days in many people and usually within 1 weeks, irrespective or whether or not the caused is Strep. infection
Common causes of sore throat?
Common cold. influenza and Strep. infection
When should infectious mononucleosis be suspected in a patient with a sore throat?
If sore throat and lethargy persist into the second week, esp. if the person is 15-25years of age
Less common causes of sore throat?
HIV, gonococcal pharyngitial (caused by Gonorrhoea) and diphtheria
Simple advice for sore throats?
Paracetamol/ibuprofen to relieve pain and fever,
Avoidance of hot drinks and adequate fluid intake
Simple mouthwashes, e.g: warm salty water at frequent intervals, until the discomfort and swelling subside
What is the Centor score?
Assist decision on whether or not antibiotics should be prescribed; one point each for: • Tonsillar exudate • Tender anterior cervical lymph nodes • Hx of fever • Absence of cough
Risk of Strep. pyogenes increases as score rises
