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A 3 year old female child presents to the walk-in clinic with a 2 day history of sore throat, runny nose, cough and diarrhea. The child had fever on day 1 of symptoms.

On physical exam, the child is afebrile with temperature of 37.3 and looks uncomfortable. Examination of the neck reveals palplable cervical lymphadenopathy bilaterally. Visualization of the orophrynx shows tonsillar exudate. Remainder of the examination is normal.

Partially Correct

Viral pharygitis is often associated with other systemic symptoms, such as coryza, cough, conjuctivitis, stomatitis, hoarseness/stridor, diarrhea and/or nonspecific rash. Fever is usually of short duration.

Findings on physical exam may not distinguish between viral and bacterial causes of pharyngitis.

Common etiologies include rhinovirus, enterovirus, adenovirus, parainfluenza, herpes simplex virus, epstein barr virus and coxsackie virus.

Gereige, R and Cunill- De Sautu, B. Throat Infections. Pediatrics in Review 2011; 32(11): 459-469.

Overview of pharyngitis, peritonsillar abscess, retropharyngeal cellulitis. Very good pictures.

Canadian Paediatric Society Position Statement. Group A Streptococcal Pharyngitis: A Practical Guide to Diagnosis and Treatment. 2021

Picture credits:

https://upload.wikimedia.org/wikipedia/commons/4/4a/Pos_strep.JPG

https://upload.wikimedia.org/wikipedia/commons/8/84/Stomatitis_herpetica.jpg

https://upload.wikimedia.org/wikipedia/commons/b/ba/Streptococcal_pharyngitis.jpg

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Authors

Mike Paget

mkpaget@ucalgary.ca

Manager - Academic Technologies - Cumming School of Medicine

Dr. Hosanna Au

Reviewer

Dr. Andrew Latchman

McMaster Pediatrics

What is the most likely diagnosis?

Streak:

Authors

Mike Paget

Dr. Hosanna Au

Reviewer

Dr. Andrew Latchman