26 American Family Physician
of one individual user of the Web site. All other rights reserved. Contact firstname.lastname@example.org for copyright questions and/or permission requests.
Volume 83, Number 1 ◆ January 1, 2011
Avoiding Sore Throat Morbidity
and Mortality: When Is It Not
“Just a Sore Throat?”
University of Alabama at Birmingham,
Huntsville Regional Medical Campus,
reasons? for? ambulatory? care? visits.? We? see?
Although? we? know? that? other? organisms?
believe? those? organisms? cause? self-limited?
ments? using? programmed? evaluation? and?
history? and? physical? examination.? This?
We? encourage? physicians,? residents,? and?
of? worsening? pharyngitis,? including? non-
with? false-negative? rapid? testing),? infec-
tious? mononucleosis,? acute? human? immu-
nodeficiency? virus? infection,? peritonsillar?
patient’s? symptoms? persist? or? worsen,? the?
diagnosis? no? longer? fits? this? category,? and?
a? more? careful? diagnostic? and? therapeutic?
which? usually? begins? with? a? sore? throat?
that? improves? over? the? first? four? to? five?
symptoms,? with? the? addition? of? bactere-
Lemierre? syndrome? occurs? most? often?
in? adolescents? and? young? adults? (ages? 15?
tis? occurs? predominantly? in? the? same? age?
group.6? A? Lemierre? syndrome? variant? can?
also? occur? before? adolescence;? however,? it?
bacterium? pharyngitis? is? readily? available.?
media? from? throat? swabs.? Blood? cultures?
Many? Lemierre? syndrome? diagnoses? occur?
syndrome.? We? believe? that? following? the?
American? College? of? Physicians/Centers?
lines? endorsed? by? the? American? Academy?
of? Family? Physicians? would? decrease? the?
risk? of? Lemierre? syndrome? in? adolescents?
Downloaded from the American Family Physician Web site at www.aafp.org/afp. Copyright © 2010 American Academy of Family Physicians. For the private, noncommercial use
Physicians? do? not? need? to? change? their? approach? to?
who? have? persistent? or? worsening? symptoms,? and? to?
tion? to? the? following? red? flags:? rigors,? shaking? chills,?
Address correspondence to Robert M. Centor, MD, FACP, at rcentor@
uab.edu. Reprints are not available from the authors.
Author disclosure: Nothing to disclose.
Medicine,? Centers? for? Disease? Control? and? Prevention.? Principles? of?
Ann Intern Med.?2001;134(6):509-517.
and?management?of?group?A?streptococcal?pharyngitis.?Clin Infect Dis.?
group?C?streptococcus.?J Gen Intern Med.?2007;22(2):272-274.
? 6.?Centor? RM.? Expand? the? pharyngitis? paradigm? for? adolescents? and?
young?adults.?Ann Intern Med.?2009;151(11):812-815.
spective?epidemiological?and?clinical?survey.?Eur J Clin Microbiol Infect