Admit
High risk features for gonacoccal pharyngitis?
Evaluate GAS risk factors:
Lozenges
Meets discharge criteria?
PO challenge if tolerable level of respiratory distress
High risk features for primary HIV?
Symptoms of a viral URI (conjunctivitis, rhinorrhea, cough, herpangina, etc.)
Consider pediatric or ENT consult
Signs of upper airway obstruction?
Consider ENT and/or Anesthesia consults, off pathway
High risk features for gonacoccal pharyngitis
Throat sprays
Discharge criteria
Contraindications (relative) to probiotics
High risk features for GAS?
> 3 years?
Discharge with follow up with PMD
Probiotics
Contraindications to probiotics?
Systemic analgesics (Acetaminophen / Paracetamol / Ibuprofen)
Alternative therapies
Systemic glucocorticoids
Non-GAS bacterial pharyngitis
High risk features for GAS
Goals of care
Potential beta-lactam therapies
Potential therapies if penicillin allergic
Potential therapies if reoccurrence
Oral rinses / salt water gargles
Throat Culture
Should GAS be tested for or treated?
Systemic analgesia (Acetaminophen/Paracetamol/Ibuprofin)
Potential alternative diagnoses
High risk features for primary HIV
1 or more sign of poor hydration: