Pharyngitis: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore:
    • Inspection (viewing).
      • Skin and mucous membranes
      • Mouth and oropharynx (areas from the soft part of the palate, the tonsils and the base of the tongue) [acute pharyngitis: inflammation of the pharyngeal mucosa without involvement of the palatine tonsils; possibly also stipples and viscous mucus deposits].
    • Palpation (palpation) of the regional lymph nodes [pressure painful swollen?]
    • Examination of the ears by otoscope / otoscopy [due topossible sequelae: otitis media (otitis media)].
    • Auscultation (listening) of the heart [due topossible sequelae: Endocarditis (meningitis, usually the heart valves are affected), myocarditis (myocarditis), pericarditis (pericardial inflammation)]
  • ENT medical examination – including endoscopy of the oral cavity and pharynx.

Square brackets [ ] indicate possible pathological (pathological) physical findings.

McIsaac score (modified Centor score): predictor of GABHS tonsillopharyngitis for patients aged 3 to 14 years.

Symptom Points
Body temperature (in the medical history) > 38 °C 1
no cough 1
cervical (“belonging to the neck”) lymph node enlargement 1
Tonsil enlargement or exudate. 1
Age: 3-14 years 1
15-44 years of life 0
≥ 45 years of life -1
McIsaac score (modified Centor score) point total Probability of GABHS detection in throat swab.
-1 or 0 1 %
1 10 %
2 ∼ 17 %
3 ∼ 35 %
4 or 5 ∼ 50 %

Centor score: predictor of GABHS tonsillopharyngitis for patients ≥ 15 years of age.

Symptom Points
Body temperature (in the medical history) > 38 °C 1
No cough 1
Cervical lymph node enlargement 1
Tonsil enlargement or exudate. 1
Centor scoreSum of points Probability of GABHS detection in throat swab.
0 ∼ 2,5 %
1 ∼ 6-7 %
2 ∼ 15 %
3 ∼ 30-35 %
4 ∼ 50-60 %

Legend: GABHS = group A beta-hemolytic streptococci.