Sore throat DDx
Sore throat can be more than a viral pharyngitis!
- Peritonsilar Abscess (quinsy)
- Infectious mononucleosis
Most patients with sore throat will have a viral or short-lived bacterial infection. However, clinicians need to be able to identify patients at risk of having group A beta-haemolytic streptococcal infections as appropriate treatment may prevent complications.
Other less common bacterial causes of pharyngitis/ tonsilitis include:
- group C and G strep, Fusobacterium necrophorum, Neisseria gonorrhoea, Corynebacterium diphtheriae, Mycoplasma pneumoniae, and several chlamydial species
Less common and/or dangerous causes of a sore throat include:
- Lemierre syndrome due to Fusobacterium necrophorum
- Retropharyngeal abscess
- Scarlet fever
- Bacterial Tracheitis
- Ludwig’s Angina
- Angioedema or anaphylaxis
- Painful cervical lymphadenopathy
- Trauma, e.g. foreign body or caustic ingestion
References and Links
- ENT Equivocation 001 — A nasty sore throat
- ENT Equivocation 002 — My throat hurts!
- Tropical Travel Trouble 011 – Tonsillitis and the Bull
- Paediatric Perplexity 016 – Frankly my dear, I do give a damn
Journal Articles and Textbooks
- Stewart, C. (2006). A “killer” sore throat: Inflammatory disorders of the paediatric airway. Pediatric Emergency Medicine Practice. (Vol3, No 6)
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC