Centor criteria
Around 90% of children and adolescents with scarlet fever also present with group A streptococcus (GAS) (Streptococcus pyogenes) pharyngitis.[14]Wu S, Peng X, Yang Z, et al. Estimated burden of group a streptococcal pharyngitis among children in Beijing, China. BMC Infect Dis. 2016 Aug 26;16(1):452.
https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-016-1775-9
http://www.ncbi.nlm.nih.gov/pubmed/27566251?tool=bestpractice.com
[15]Herdman MT, Cordery R, Karo B, et al. Clinical management and impact of scarlet fever in the modern era: findings from a cross-sectional study of cases in London, 2018-2019. BMJ Open. 2021 Dec 24;11(12):e057772.
https://bmjopen.bmj.com/content/11/12/e057772.long
http://www.ncbi.nlm.nih.gov/pubmed/34952887?tool=bestpractice.com
The Centor score estimates the probability of GAS pharyngitis in patients ages ≥15 years. A score of 1 point is assigned to each of the following criteria:[24]Windfuhr JP, Toepfner N, Steffen G, et al. Clinical practice guideline: tonsillitis I. Diagnostics and nonsurgical management. Eur Arch Otorhinolaryngol. 2016 Apr;273(4):973-87.
https://link.springer.com/article/10.1007/s00405-015-3872-6
http://www.ncbi.nlm.nih.gov/pubmed/26755048?tool=bestpractice.com
[25]Centor RM, Witherspoon JM, Dalton HP, et al. The diagnosis of strep throat in adults in the emergency room. Med Decis Making. 1981;1(3):239-46.
http://www.ncbi.nlm.nih.gov/pubmed/6763125?tool=bestpractice.com
Tonsillar swelling or exudate
Tender anterior cervical adenopathy
No cough
Temperature >100.4°F (>38.0°C).
Patients with a total score of ≥3 should be considered for rapid antigen detection testing or culture for GAS from a throat swab.[24]Windfuhr JP, Toepfner N, Steffen G, et al. Clinical practice guideline: tonsillitis I. Diagnostics and nonsurgical management. Eur Arch Otorhinolaryngol. 2016 Apr;273(4):973-87.
https://link.springer.com/article/10.1007/s00405-015-3872-6
http://www.ncbi.nlm.nih.gov/pubmed/26755048?tool=bestpractice.com
McIsaac criteria
This McIsaac score uses the same criteria as the Centor score, but corrects for age and so it can be used in children and in adults.[35]McIsaac WJ, White D, Tannenbaum D, et al. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ. 1998 Jan 13;158(1):75-83.
https://www.cmaj.ca/content/cmaj/158/1/75.full.pdf
http://www.ncbi.nlm.nih.gov/pubmed/9475915?tool=bestpractice.com
[39]McIsaac WJ, Kellner JD, Aufricht P, et al. Empirical validation of guidelines for the management of pharyngitis in children and adults. JAMA. 2004 Apr 7;291(13):1587-95.
https://jamanetwork.com/journals/jama/fullarticle/198485
http://www.ncbi.nlm.nih.gov/pubmed/15069046?tool=bestpractice.com
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Sore Throat (Pharyngitis) Evaluation and Treatment Criteria (McIsaac)
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As with the Centor score, patients with a total score of ≥3 should be considered for rapid antigen detection testing or culture for GAS from a throat swab.[24]Windfuhr JP, Toepfner N, Steffen G, et al. Clinical practice guideline: tonsillitis I. Diagnostics and nonsurgical management. Eur Arch Otorhinolaryngol. 2016 Apr;273(4):973-87.
https://link.springer.com/article/10.1007/s00405-015-3872-6
http://www.ncbi.nlm.nih.gov/pubmed/26755048?tool=bestpractice.com