Sore throat is a very common and vague symptom that can be associated with a variety of conditions ranging from bacterial or viral infections to the malignancy of throat or neck. It is one of the top 20 reasons for patient visits to their primary care provider (Ruppert, 2015). Therefore, a thorough history taking, physical examination, and necessary diagnostic work up should be done to eliminate various differential diagnoses and before choosing a final diagnosis. This is important to provide the appropriate treatment.
When a patient comes with a chief complaint of “sore throat”, as a provider in order to come to a final diagnosis, it is crucial to ask questions about their current signs and symptoms. Taking a thorough history includes asking questions such as onset, duration, and severity of sore throat; associated symptoms; precipitating factors; alleviating factors; treatment done so far; and also any past history of illness. A detailed physical examination is necessary to visualize the structures of the throat. Examination of the throat may reveal generalized erythema of the pharynx or tonsils, enlargement of the tonsils and/or presence of exudate with some cervical lymphadenopathy (Goolsby & Grubbs, 2015).
Following are three differential diagnoses for a patient who comes in with complains of sore throat
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It can be bacterial or viral. The symptoms of tonsillitis are fever, sore throat, foul breath, difficulty swallowing, painful swallowing, trismus (unable to open mouth), and tender cervical lymph nodes (Stelter, 2014). A throat examination will show red, swollen tonsils, and white or yellow exudate on tonsils. A rapid strep test using a throat swab can be done to distinguish this from strep throat. If strep is not indicated, a throat swab and culture can be done to determine if the cause for the swollen tonsils is bacterial. If the culture is negative, it can be assumed that the infection is