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Can throat examination distinguish between bacterial and viral infective agents?

Report by: Helen Slee, Medical Student

Search checked by: Kevin Mackway-Jones, Consultant Emergency Medicine

Institution: Manchester Royal Infirmary

Three-part question

In (patients with acute sore throat) is (clinical examination alone better than clinical examination and investigation) at (determining whether the infective agent is bacterial or viral)?

Clinical scenario

An 8-year-old presents to A&E with a sore throat and anterior cervical lymphadenopathy and a 3-day history of a cough. She is examined and told it is probably just a virus. Is there any evidence for this statement or should she be investigated further?

Search strategy

Medline 1966 to June week 1 2005.

Embase 1980 to 2005 week 24.

Cinahl Cumulative Index to Nursing & Allied Health Literature 1982 to June week 1 2005.

The Cochrane Library Issue 2 2005.

(Exp PHARYNGITIS/OR exp LARYNGITIS/OR exp TONSILLITIS/OR exp …

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