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A 24-year-old man presents with 3 days of sore throat, fever, and painful swallowing. No cough or rhinorrhea. Exam reveals erythematous tonsils with exudates and tender anterior cervical nodes. Temp: 38.4°C.
Question:What is the evidence-based stepwise approach to evaluating and treating suspected tonsillitis?
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A
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Evaluate for fever and cervical lymphadenopathy
Perform rapid antigen detection test or throat culture
Assess for Centor criteria
Check for absence of cough
Advise supportive care (hydration, analgesics)
Educate on symptom monitoring and red flags
Decide on empiric antibiotics if high score
Prescribe penicillin or amoxicillin for streptococcal tonsillitis
Reassess if no improvement in 48–72 hours
Consider alternative diagnosis if test negative
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1
Assess for Centor criteria
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Check for absence of cough
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Evaluate for fever and cervical lymphadenopathy
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4
Perform rapid antigen detection test or throat culture
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Decide on empiric antibiotics if high score
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Prescribe penicillin or amoxicillin for streptococcal tonsillitis
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Advise supportive care (hydration, analgesics)
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Educate on symptom monitoring and red flags
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Consider alternative diagnosis if test negative
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Reassess if no improvement in 48–72 hours
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Tonsillitis
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