Questionnaire/history: Sore throat? Pain on swallowing? Non-specific symptoms? - Headache? - Nausea? - Vomiting? - Abdominal pain? - Fever? - Other? Dehydration? - Number of wet nappies (babies)? - Fluid intake reduced (50% or 75% of normal volume)? Past medical history? Current medication? Drug allergies? Examination: Signs of clinical dehydration? - Reduced skin turgor? - CRT > 3 seconds? - Dry mucous membranes? FeverPAIN score? - Fever > 38°C? - Purulence (pharyngeal/tonsillar exudate)? - Attend rapidly (3 days or less)? - Severely inflamed tonsils? - No cough or corzya? Centor score? - Tonsillar exudate? - Tender anterior cervical lymphadenopathy or lymphadenitis? - Fever > 38°C? - Absence of cough? Investigations: - Rapid antigen test for gorup A streptococcus if high risk of RF? - Very old or young? - Risk of immunosupression? - Severe symptoms? - Thorat culture if negative antigen test with suspected GAS? Differential diagnosis Management Reference(s): NICE CKS: Sore throat