SORE THROAT
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SORE THROAT. Most people don't need antibiotics!. 85% get better in a week. CAUSES. Viruses 20% (rhino/adeno/parainfluenza) Bacteria 17% (GABHS) Thrush (post Abx/immunosupressants) Chemical irritation (inhaler technique) Allergy (dust) Smoking (chronic sore throat) Cancer TB

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SORE THROAT

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Sore throat

SORE THROAT


Sore throat

Most people don't need antibiotics!

85% get better in a week


Causes

CAUSES

  • Viruses 20% (rhino/adeno/parainfluenza)

  • Bacteria 17% (GABHS)

  • Thrush (post Abx/immunosupressants)

  • Chemical irritation (inhaler technique)

  • Allergy (dust)

  • Smoking (chronic sore throat)

  • Cancer

  • TB

  • Tonsillitis

  • Glandular Fever

….which is the most common cause?


Sore throat

FEVER

Tender anterior

cervical nodes

Tonsilar exudates

No cough

CENTOR Criteria

Higher risk GABHS

If 3/4 + unwell = 1:60 risk quinsy

(1:400 if well)


Treatment

Treatment

  • Stall them! See if it goes away:

    • Paracetamol gargle/Ibuprofen

    • Difflam

    • Lozenges

  • Penicillin V 500mg qds 10days

  • Delayed scripts

  • More likely to reattend if given Abx

  • Tonsillectomy if >3/y, >5/2y


Glandular fever

Glandular Fever

  • 98% sore throat, lymphadenopathy, fever + tonsillar enlargement

  • Self Limiting (rest, fluids, antipyretics)

  • Don’t give Amox as risk rash

  • Older people more likely to get hepatomegaly + jaundice


Pretty geeky song

Pretty geeky song…

I heard there’s sore throat going round

That brings most people to the ground

But actually, it’s just tonsillitis…

It starts with pain and fever too

Anterior lymph node tenderness

And all the stuff in Centor’s criteria…

And you look inside and see the pus

It’s sore and it’s red

And then you say, my god, you got tonsillitis…

My poor sore throat

Could be tonsillitis

Or glandular fever

Or just a virus

My poor sore throat

Needs penicillin…


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