Pediatric Sore Throat Is Negative for GERD, Strep and Mono--What Now?

PROGRAM DESCRIPTION: As otolaryngologists we are consulted as experts on chronic and recurrent sore throat, yet we find ourselves at a loss for what to do when patients are not surgical candidates and when Group A streptococcus, GERD, or Mono have been ruled out. Such shallow and limited consultations often leave patients and referring providers disappointed and frustrated. Missing is a practical evidence-based discussion reaching beyond the guidelines which, by design limit topics to the most common defined etiology. All patients must be seen by the front-line providers and many such patients do not neatly fit into a narrowly defined guideline box and have real symptoms never once confirmed as Group A streptococcus. Via an interactive case-oriented approach during which several cases will be presented, audience response will be solicited for consensus of diagnostic, medical, or surgical opinions. Less common entities specifically excluded from the guidelines such as PFAPA and PANDAS will be included as will common questions such as the significance of atypical mycobaterial pharyngotonsillitis, Group B, C & G streptococcus, often discounted as "normal flora" but relevant and warranting treatment. Ostensible inconsistencies and disagreements between surgical guidelines (AAO-HNS guidelines) and medical guidelines (IDSA-Infectious Disease Society of America) will be explained. Many who refer patients to us are more influenced by guidelines from their medical vs. our surgical academy. This expert series will be a comprehensive compliment to the more common discussion in order to empower otolaryngologists and advanced practice providers to understand that "all that is sore is not strep throat!"

OUTCOME OBJECTIVE 1: Interpret data defining uncommon etiologies for sore throat including serology and atypical pathogens

OUTCOME OBJECTIVE 2: Recognize diagnostic, medical and surgical options in patients with less commonly diagnosed adenotonsillar diseases

OUTCOME OBJECTIVE 3: Implement and understand "what is next" in patients without strep throat, mono, or GERD and who present as exclusions to current guidelines.

BACKGROUND STATEMENT: There is a paucity of educational opportunities discussing sore throat patients who do not meet surgical criteria, do not have strep throat/GERD/Mono or who are not included in best-practice guidelines. Those in the front line of clinical practice have little to guide diagnosis &
treatment.

Comprehensive Otolaryngology Track Statement : Sore throat consultations are commonplace in the daily practice of comprehensive otolaryngologists and patients must be approached in a holisitic manner with equal attention to medical and surgical issues. There is no need to rely on infectious disease and GI experts if we are thoughtful.