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Streptococcal Pharyngitis

Note the exudate on the left tonsil in this 16 year old patient. Odynophagia is usually significant. Rapid confirmation is possible using the rapid strep test.

Patients who fulfil 2 of the following 3 criteria can be presumed to have Strep pharyngitis and can be empirically treated.

  1. Fever

  2. pharyngeal exudates

  3. Tender cervical lymphadenopathy

Treatment of choice is Oral penicillin for 10 days. If compliance is a problem (whch it usually is in these adolescent patients) then Benzathine PCN injection is good. Erythro and its family are good in those allergic to PCN.