Criteria

Centor criteria[19]

The Centor criteria give an indication of the likelihood of a sore throat being due to bacterial infection. The criteria that give +1 are:

  • Tonsillar exudate

  • Tender anterior cervical adenopathy

  • Fever over 38°C (100.5°F) by history

  • Absence of cough.

If 3 or 4 of Centor criteria are met, the positive predictive value is 40% to 60%. The absence of 3 or 4 of the Centor criteria has a fairly high negative predictive value of 80%.

Streptococcal score card[5]

The streptococcal score card gives an indication of the likelihood of a sore throat being due to infection with group A beta-haemolytic streptococci (GABHS). The criteria are:

  • Age 5 to 15 years

  • Season (late autumn, winter, early spring)

  • Fever (≥38.3°C [≥101°F])

  • Cervical lymphadenopathy

  • Pharyngeal erythema, oedema, or exudate

  • No symptoms of a viral upper respiratory infection (conjunctivitis, rhinorrhoea, or cough).

If 5 of the criteria are met, a positive culture for GABHS is predicted in 59% of children; if 6 of the criteria are met, a positive culture is predicted in 75% of children.

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