Is it Virus or Bacteria?
The Centor Scoring System may help to differentiate between GABHS and viral causes on the basis of symptoms and clinical signs by categorizing the individual patient’s risk level for GABHS infection.
Centor Score
The Centor score gives one point each for:
- Tonsillar exudate
- Tender anterior cervical lymph nodes
- History of fever
- Absence of cough
Centor Score (Modified/McIsaac) for Strep Pharyngitis
| Criteria | Points |
|---|---|
| Age | |
| 3-14 | +1 |
| 15-44 | 0 |
| ≥45 | -1 |
| Exudate | |
| No | 0 |
| Yes | +1 |
| Tender swollen ACLN | |
| No | 0 |
| Yes | +1 |
| Temp. <38 (100.4) | |
| No | 0 |
| Yes | +1 |
| Cough present | |
| No | 0 |
| Yes | 0 |
 |
Is it Virus or Bacteria?
- The likelihood of GABHS infection increases with increasing score.
- Streptococcal infection is most likely in the 5–15 year old age group and gets progressively less likely in younger or older patients.
- The score isn’t validated for use in children under three years.
- The score should be used to assist the decision on whether to prescribe an antibiotic, but cannot be relied upon for a precise diagnosis.