LiverpoolMedics - Resource for Liverpool Medics - Students Studying Medicine in Liverpool UK

The Centor Criteria¹ are a set of criteria which may be used to identify the likelihood of a bacterial infection in adult patients complaining of a sore throat. They were developed as a method to quickly diagnose the presence of Group A streptococcal infection or a diagnosis of Streptococcal Pharyngitis in "adult patients who presented to an urban emergency room complaining of a sore throat." The Modified Centor Criteria² takes account of the patient's age.

You must give information about all five assessments - fever, tonsillar exudate, tender anterior cervical adenopathy, cough and age - in order to determine a Centor score for this patient.

Fever:

yes

no

Tonsillar exudates:

yes

no

Tender anterior cervical adenopathy:

yes

no

Absence of cough:

yes

no

Age:

< 15 years

15-44 years

> 44 years

The presence of all four variables indicates a 40 - 60% positive predictive value for a culture of the throat to test positive for Group A Streptococcus bacteria. The absence of all four variables indicates a negative predictive value of greater than 80%³. The high negative predictive value suggests that the Centor Criteria can be more effectively used for ruling out streptococcal throat infection than for diagnosing streptococcal throat infection.

References:

Centor RM, Witherspoon JM, Dalton HP, Brody CE & Link K (1981). "The diagnosis of Streptococcal throat infection in adults in the emergency room". Medical Decision Making 1 (3): 239246.
McIsaac WJ, Kellner JD, Aufricht P, Vanjaka A & Low DE (7 April 2004). "Empirical Validation of Guidelines for the Management of Pharyngitis in Children and Adults". Journal of the American Medical Association 291 (13): 15871595.
Marín Cañada J, Cubillo Serna A, Gómez-Escalonilla Cruz N, Garzón de la Iglesia J, Benito Ortiz L, Reyes Fernández MN (July 2007). "Is streptococcal pharyngitis diagnosis possible?". Aten Primaria (in Spanish) 39 (7): 361–365.

Last Update: 31 January 2008