Sore Throat: 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 throat).
  • ENT medical examination [due todifferential diagnoses:
    • Acute laryngitis (inflammation of the larynx).
    • Acute pharyngitis (pharyngitis)
    • Acute tonsillitis (tonsillitis)
    • Chronic laryngitis (inflammation of the larynx).
    • Chronic pharyngitis (pharyngitis)
    • Chronic tonsillitis (deficiency inflammation)
    • Epiglottis abscess – encapsulated collection of pus in the area of the epiglottis.
    • Epiglottitis (inflammation of the epiglottis)
    • Palatine tonsillar hyperplasia – enlargement of the palatine tonsil.
    • Laryngeal perichondritis – inflammation of the tissue surrounding the cartilage in the area of the larynx.
    • Laryngeal phlegmon – diffuse inflammation of the connective tissue surrounding the larynx.
    • Parapharyngeal abscess – encapsulated accumulation of pus in the throat.
    • Peritonsillar abscess – encapsulated collection of pus in the area of the tonsils (lymphatic pharyngeal ring).
    • Peritonsillitis – inflammation of the tonsils and surrounding tissue]

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.