Evaluation and Management of Patients With Pharyngitis in Urgent Care (Pharmacology CME) -
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Publication Date: October 2022 (Volume 1, Number 7)

CME Credits: 4 AMA PRA Category 1 Credits™. CME expires 10/01/2025.

Specialty CME: Included as part of the 4 credits, this CME activity is eligible for 2 Pharmacology CME credits, subject to your state and institutional requirements.

Editor-in-Chief & Update Author

Keith A. Pochick, MD, FACEP

Attending Physician, Urgent Care, Charlotte, NC

Urgent Care Peer Reviewer

James B. Short, Jr., MD, FAAFP, BCUCM

Director, Piedmont Urgent Care, Atlanta, GA

Linda Aanonsen, PA-C

Clinical Physician Assistant, GoHealth Urgent Care, Staten Island, NY

Charting & Coding Author

Brad Laymon, PA-C, CPC, CEMC

Certified Physician Assistant, Winston-Salem, NC

Abstract

Sore throat is one of the most common presenting complaints in outpatient medicine, so urgent care clinicians must be experts in evaluating and treating patients with pharyngitis. The differential diagnosis for pharyngitis is broad and includes a few serious disease processes that must be quickly ruled out. This issue reviews international guidelines for pharyngitis and discusses controversies and recent advances in diagnostic and treatment strategies, specifically for management of suspected bacterial and viral etiologies.

Case Presentations

CASE 1

A 2-and-a-half-year-old girl with a sore throat is brought to UC by her mother...

The patient refuses to eat and has been complaining of pain for 2 days; her mother reports that she has had “low-grade” fevers.
The girl does not attend daycare. She looks well overall and is drinking from a juice box in the examination room.
The patient’s mother asks you to prescribe an antibiotic for the child's “strep throat.”
You wonder if antibiotics are the appropriate management choice for this patient…

CASE 2

A 20-year-old man presents to UC complaining of 2 days of sore throat…

He is febrile with a temperature of 38.4° C. He has bilateral tonsillar erythema and exudates, and tender cervical adenopathy.
He has not been coughing, is able to eat and drink, and does not have any trouble breathing, but he is asking for pain medication.
You wonder whether any testing is needed for this patient, and how you should treat him…

CASE 3

A 35-year-old woman with 6 days of sore throat presents with voice changes...

She describes a change of intonation but no hoarseness.
She looks well but insists her voice sounds quite different. She has odynophagia without any other associated symptoms.
You wonder if this patient needs urgent intervention…

CASE 4

A 62-year-old man arrives after several weeks of sore throat and hoarseness...

He states that he has not had a fever or other upper respiratory symptoms, and has no known exposures, but his primary symptoms have been gradually worsening. He is a smoker.
You wonder if this could be a noninfectious etiology…

Accreditation:

EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.