The Cardiovascular
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FeverPAIN score for strep pharyngitis

Likelihood of streptococcal sore throat.

FeverPAIN score for strep pharyngitis
Fever in the past 24 hours
Purulence (pus on tonsils)
Attend rapidly (within 3 days of symptom onset)
Severely inflamed tonsils
No cough or coryza
Result0 points

Low likelihood of streptococcus; antibiotics generally not indicated.

Estimated streptococcus
13-18 %

When to use

  • Guiding antibiotic decisions in acute sore throat in patients aged >=3 years.

Formula

One point each: Fever (24 h), Purulence, Attend rapidly (<=3 days), severely Inflamed tonsils, No cough/coryza. Range 0-5.

Pearls and pitfalls

  • Score 0-1: ~13-18% strep; 2-3: ~34-40%; 4-5: ~62-65%.

References

  1. Little P, et al. BMJ Open. 2013;3(10):e003943.