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Sore throat - acute - Management
When should I admit?
- Admit immediately anyone who has:
- Stridor or respiratory difficulty.
- Respiratory distress, drooling, systemically very unwell, painful swallowing, muffled voice: suspect acute epiglottitis. Do not examine the throat of anyone who has suspected epiglottitis.
- Upper airway obstruction.
- Dehydration or reluctance to take any fluids.
- Severe suppurative complications (e.g. peri-tonsillar abscess or cellulitis, parapharyngeal abscess, retropharyngeal abscess, or Lemierre syndrome) as there is a risk of airway compromise or rupture of the abscess.
- Signs of being markedly systemically unwell and is at risk of immunosuppression.
- Suspected Kawasaki disease.
- Diphtheria: characteristic tonsillar or pharyngeal membrane.
- Signs of being profoundly unwell and the cause is unknown or a rare cause is suspected, for example:
- Stevens–Johnson syndrome: high fever, arthralgia, myalgia, extensive bullae in the mouth followed by erosion and a grey–white membrane.
- Yersinial pharyngitis: fever, prominent cervical lymphadenopathy, abdominal pain with or without diarrhoea.
Basis for recommendation
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