Question 83 · LEK · Acute pharyngitis and tonsillitis
A woman comes to the GP with her 4-year-old daughter, who has had a fever up to 39.5 ºC since the morning. The child complains of strong sore throat too. The physical examination reveals enlarged tonsils covered with white exudate and pus plugs. Anterior cervical lymph nodes are also enlarged. The clinical image allows the diagnosis of:
- A. acute pharyngitis, 2 points on the Centor/McIsaac score, no indications for antibiotic therapy.
- B. infectious mononucleosis, there is no indications for antibiotic therapy.
- C. acute streptococcal pharyngitis and tonsillitis, 4 points on the Centor/McIsaac score; antibiotic therapy is indicated without need for the rapid strep test.
- D. acute streptococcal pharyngitis and tonsillitis, but the decision on antibiotic therapy should be based on the rapid strep test result.
- E. scarlet fever, the antibiotic therapy is necessary.
Hint
Calculate the McIsaac score, then recall whether Polish guidelines allow antibiotics in children without microbiological confirmation.
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