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The Centor criteria are a clinical tool used to predict the likelihood of Group A Streptococcal pharyngitis (GAS) as the cause of a sore throat. This helps guide decisions on antibiotic use, especially to avoid overprescribing.

Centor Criteria:

Each of the following earns 1 point:
1. Fever: History or presence of a fever (≥38°C or 100.4°F).
2. Tonsillar exudates: Presence of white or yellowish exudates on the tonsils.
3. Tender anterior cervical lymphadenopathy: Painful or swollen lymph nodes in the anterior cervical chain.
4. Absence of cough: A lack of cough suggests bacterial rather than viral infection.
5. Age (Modified Centor Criteria adds age):
• Age <15 years: Add 1 point.
• Age ≥45 years: Subtract 1 point.

Scoring and Management:
• 0-1 points:
• Risk: Low probability of GAS infection (<10%).
• Management: No testing or antibiotics. Symptomatic treatment (e.g., NSAIDs, throat lozenges).
• 2-3 points:
• Risk: Moderate probability of GAS infection (20-30%).
• Management:
• Perform a rapid antigen detection test (RADT) or throat culture.
• Antibiotics if RADT or culture is positive.
• 4-5 points:
• Risk: High probability of GAS infection (≥50%).
• Management:
• Empirical antibiotics or confirm with RADT/throat culture.

Antibiotic Recommendations (if GAS confirmed or highly suspected):
1. First-line:
• Penicillin V (Adults: 500 mg BID or TID for 10 days; Children: 250 mg TID for 10 days).
• Amoxicillin (preferred in children due to taste, 50 mg/kg/day in 2-3 doses for 10 days).
2. Penicillin allergy (non-severe):
• Cephalexin (500 mg BID for 10 days).
3. Penicillin allergy (severe):
• Clindamycin (300 mg TID for 10 days).
• Azithromycin (500 mg on day 1, then 250 mg daily for 4 days; higher risk of resistance).

When to Avoid Antibiotics:
• Most sore throats are caused by viruses (e.g., rhinovirus, influenza, Epstein-Barr virus in mononucleosis).
• Antibiotics are not indicated for viral pharyngitis or mild symptoms without Centor criteria.

Rationale:

Appropriate antibiotic use for sore throat reduces:
1. Symptom duration in GAS pharyngitis.
2. Risk of complications such as rheumatic fever or peritonsillar abscess.
3. Overprescription and antibiotic resistance.

Summary:

The Centor criteria provide a structured approach to assess sore throat etiology. Testing or antibiotics are recommended based on the score, ensuring judicious use of antibiotics while addressing bacterial infections effectively.

صباح البرد
اجاك مريض sore throat
Tonsillitis
تنطي antibiotic لو لا
وليش ؟

منقول
HMPV

🦠 What is HMPV? Human Metapneumovirus (HMPV) is a respiratory virus that can cause infections in the upper and lower respiratory tract.
It is closely related to the respiratory syncytial virus (RSV) and shares similar symptoms.

😷 Symptoms HMPV symptoms can range from mild to severe, including cough, fever, wheezing, nasal congestion, and difficulty breathing.
In more severe cases, it can lead to pneumonia or bronchiolitis, particularly in young children and the elderly.

👶 Vulnerable Populations Infants, the elderly, and those with weakened immune systems are at higher risk of severe illness from HMPV.
People with chronic respiratory conditions like asthma or COPD are also more susceptible to complications.

🩺 Diagnosis HMPV can be diagnosed through laboratory tests, such as PCR (Polymerase Chain Reaction) or antigen testing, typically done from nasal or throat samples.
It may be difficult to distinguish from other respiratory viruses based solely on symptoms.

💉 Treatment and Prevention There is no specific antiviral treatment for HMPV.
Management is generally supportive, focusing on symptom relief with rest, fluids, and over-the-counter medications for fever and pain.
Preventive measures include good hygiene practices, such as frequent handwashing, and avoiding close contact with infected individuals.