Clerkship Ready: Pediatrics

Before You See a Pediatric Patient with Sore Throat

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Listen along as we dive into the many causes of sore throat. Learn about the common causes such as allergies and viral illnesses while also what to do when a child with epiglottitis comes in.  We will cover CENTOR criteria as well and when you should think about Group A strep testing.

Common Causes

  • Viral Presentation
    • HSV
    • Mononucleosis
    • Allergic Presentation
    • Group A Strep 
      • CENTOR Criteria

        • Emergency Causes

        • Peritonsillar Abscess
        • Retropharyngeal Abscess
        • Epiglottitis

          • Wrap Up & Conclusion

           

          Resources/Links:

          https://www.chop.edu/conditions-diseases/throat-anatomy-and-physiology 

          https://www.mdcalc.com/calc/104/centor-score-modified-mcisaac-strep-pharyngitis 

           

          References

          1. Aluma Chovel-Sella, Amir Ben Tov, Einat Lahav, Orna Mor, Hagit Rudich, Gideon Paret, Shimon Reif; Incidence of Rash After Amoxicillin Treatment in Children With Infectious Mononucleosis. Pediatrics May 2013; 131 (5): e1424–e1427. 10.1542/peds.2012-1575
          2. Becker JA, Smith JA. Return to play after infectious mononucleosis. Sports Health. 2014 May;6(3):232-8. doi: 10.1177/1941738114521984. PMID: 24790693; PMCID: PMC4000473.
          3. Chowdhury MDS, Koziatek CA, Rajnik M. Acute Rheumatic Fever. [Updated 2023 Aug 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK594238/
          4. Esposito, S.; De Guido, C.; Pappalardo, M.; Laudisio, S.; Meccariello, G.; Capoferri, G.; Rahman, S.; Vicini, C.; Principi, N. Retropharyngeal, Parapharyngeal and Peritonsillar Abscesses. Children 2022,9,618. https://doi.org/ 10.3390/children9050618 
          5. Martin JM. The Mysteries of Streptococcal Pharyngitis. Curr Treat Options Pediatr. 2015 Jun;1(2):180-189. doi: 10.1007/s40746-015-0013-9. PMID: 26146604; PMCID: PMC4486489.
          6. MCMILLAN, J. A. , WEINER, L. B. , HIGGINS, A. M. & LAMPARELLA, V. J. (1993). Pharyngitis associated with herpes simplex virus in college students. The Pediatric Infectious Disease Journal, 12 (4), 280-283.
          7. Mohseni M, Boniface MP, Graham C. Mononucleosis. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470387/
          8. Roggen I, van Berlaer G, Gordts F, et al. Centor criteria in children in a paediatric emergency department: for what it is worth. BMJ Open 2013;3: e002712. doi:10.1136/ bmjopen-2013-002712 
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