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After completing this case study, the reader should be able to:

  • List the subjective and objective information that a healthcare professional must gather from a patient with pharyngitis.

  • Assess the need for antibiotic therapy in a patient with pharyngitis based on signs and symptoms and the results from microbiological and immunologic diagnostic studies.

  • Prepare an evidence-based care plan for a patient with acute pharyngitis that is individualized to the patient’s current presentation, past medical history, and concurrent medications.

  • Identify the key educational and counseling points needed by the patient and/or caregivers to safely and effectively implement the therapeutic plan and to prevent disease transmission.

  • List the parameters monitored by the healthcare professional to ensure clinical resolution and the prevention of suppurative and nonsuppurative complications of acute pharyngitis.


Chief Complaint

“It hurts to swallow.”


A 16-year-old girl presents to her community pharmacy complaining of sore throat and requests help finding an over-the-counter product to alleviate her symptoms. Her mother reports a fever of 102°F (38.9°C) on and off for the past 24 hours, and observes that she has been more tired over the past 2 days. She has been drinking only liquids since this time. She endorses a bumpy rash on her face and neck that has spread to her chest and arms. She denies cough, shortness of breath, or difficulty breathing. The patient complains of nausea and headaches but denies vomiting. Mother notes no recent illness in the family.


The patient has had prior cases of otitis media as a young child. Six months ago, she was diagnosed with primary dysmenorrhea. Otherwise, she is healthy. Immunization records indicate receipt of the following immunizations:

  • HepB: four doses (last dose age 12 months)

  • DTaP: five doses (last dose age 4 years)

  • Tdap: one dose given at age 11

  • Hib: four doses (last dose age 12 months)

  • PCV: four doses (last dose age 12 months)

  • IPV: four doses (last dose age 4 years)

  • MMR: two doses (last dose age 12 months)

  • Varicella: two doses (last dose age 12 months)

  • MenACWY-D: one dose given at age 11

  • Influenza IIV/LAIV: last received at age 15

  • COVID-19 VACCINE, mRNA: two doses (last dose age 16 years)




She lives with her parents and 12-year-old twin sisters. She started high school 2 years ago and is on the varsity lacrosse team. She denies the use of tobacco, alcohol, marijuana, or other substances.


  • Ethinyl estradiol 20 mcg/levonorgestrel 0.1 mg (21 ...

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