The diagnosis of pharyngitis (pharyngitis) is initially made on the basis of the clinical appearance and the symptoms described by the patient.
Second-order laboratory parameters-depending on the results of the history, physical examination, etc.-are used for differential diagnostic clarification
- Throat swab – if bacterial pharyngitis is suspected [Note: approximately 50-80% of pharyngitis is caused by viruses! A throat swab is justifiable from a medium Centor score, see below “Physical examination”]
- Tonsil smear for pathogen and resistance or rapid test for group A beta-hemolytic streptococci (GABHS); compared with culture, this has a specificity (probability that actually healthy persons who do not have the disease in question are also recognized as healthy in the test) of 95%, while the sensitivity (percentage of diseased patients in whom the disease is detected by the use of the test, i.e., a positive test result occurs) is significantly lower at 70-90%.
Specimen collection: press down the tongue with a spatula and pass the swab under vision “rubbing-turning” over both tonsils (pharyngeal tonsils) or the lymphatic side strands and the posterior pharyngeal wall.
- Small blood count – if Plummer-Vinson syndrome is suspected.
- Determination of SS-A and SS-B antibodies – if Sjögren’s syndrome is suspected.
- Mononucleosis rapid test – when mononucleosis (mononucleosis) is suspected; which is associated with whitish coatings and lymphadenopathy (lymph node enlargement).
- If necessary, serology: antibodies against adenoviruses, coxsackie viruses, ECHO viruses, influenza A and B viruses, chlamydia, Epstein-Barr virus (EBV), streptococci (ASL), parainfluenza viruses, respiratory syncytial virus (RSV).
