Patient Presentation
A 3.5-year-old male came to clinic with his mother because of large reactions to bug bites for the past 2 days. The mother was concerned because he kept scratching and had no relief from an over the counter steroid cream. There was some increased redness around a couple of them with one looking like it was particularly irritated. There were no systemic symptoms.

The pertinent physical exam showed a well-appearing male with normal vital signs and growth parameters. The skin examination revealed several reddened lesions on his extremities, neck and face. His lower legs had 2 lesions that appeared more erythematous than the others with a central area that had drainage and a small scab. This was more tender also than the central parts of other lesions.

The diagnosis of bug bites with two lesions with localized mild cellulitis was made. He was started on mupirocin for the cellulitis and oral cetirizine for pruritis. “I also wanted to followup on his language since we last talked. His repeating of words doesn’t seem to be getting better. His teacher at daycare says the same thing. He’s a happy kid, but some people think he’s a little quirky. He still plays by himself mostly, and still does more playing next to the other kids rather than with them. His teacher says he does get frustrated with toys, or changing some routines but not that is a lot different from the other kids. At home I see him repeating things, but I keep talking to him. I talked with my husband and we’re ready now to see someone about this,” she stated. The pediatrician replied, “I noticed today that he seems to be a happy child, but he was repeating a lot of what we said like “bug bites” and “get up on the table.” “Yes, he does that and at home sometimes he gets frustrated with me not really understanding what he is trying to say. If I ask, “Can you tell me?” he’ll just repeat that and it’s hard to help him,” she said. The pediatrician responded, “We talked before about having him seen by the developmental specialist and I’m also going to send you to a speech-therapist to see how they can help him be less frustrated with his language. We already tested his hearing before so we know that is not the problem with his speech.”

Discussion
Echolalia is the repetition of a part of whole of what was said, whether or not it was understood by the person. It is “echoed” or borrowed speech from someone else. “Echolalia has many forms heard in everyday speech, such as quoting or mimicking one another, doing comedic impressions, acting out dialogue in plays or counselors reflecting utterances of clients….It is also common to use literal and partial repetitions as turn-taking strategies to maintain conversational discourse….Echolalic speech, although most common before 36 months in typical language development, can have appropriate communicative functions across the lifespan in all speakers.” Immediate imitation of speech may be helpful for learning vocabulary, while recombining phrases may be helpful for learning syntax. Echolalic speech is very common up to 3 years and then disappears gradually as the child reaches linguistic proficiency. Echolalic speech can be normal or atypical behavior depending on the situation.

Learning Point
Echolalia may be the only term for repetitive speech patterns that a non-specialist provider may know when a more specific- or other diagnosis is more accurate or actually the case. Referral to a speech-language pathologist for further evaluation of repetitive speech past the normal developmental age, or that is causing communication problems is important. Little is lost and much is potentially gained with referral if there is any suspicion of a speech-language problem.

Immediate echolalia is when the utterance is produced within 2 conversational turns, while delayed occurs after more than two conversational turns or is of a higher linguistic complexity than the individual would speak themselves or is a learned routine. Echolalic utterances need to be differentiated from those that are self-generated and produced independently and creatively. “Nonlingistic vocalizations (e.g. humming, laughing, crying, whistling, vegetative sounds such as burping, ticlike squeals, grunts, hoots) are not echolalia.” Vocal stereotypies may include echolalia and nonlinguistic vocalizations and are unrelated to the current situational context. For example, when interacting in the office setting, the patient says “Let’s swing” when not at the playground. The patient is using the verbal stereotypy to express being happy or excited to be playing with the examiner. Palilalia is the repetition of an entire word (“I’m Marie, Marie, Marie,…”). Logoclonia is the last syllable of the word being repeated (“I’m Marie, re, re, re, …”). Echologia is the echoing of a question but using different words/wording. Verbigeration is when one or more sentences or sentence fragments are repeated.

Echolalic speech is often thought of as a compensatory communication strategy for people whose linguistic proficiency is too weak to respond spontaneously. While echolalic speech is very common in all young patients, after age 3 the frequency of echolalic speech increases for patients with autism and decreases for those that are neurotypical. Echolalia is one of the main characteristics in patients with autism. It can be used by autistic patients to “…affirm, call, request, label, protest, relate information, perform verbal routines and offer instructions….[it can also be used] as a turn-taking device in maintaining social interactions, to serve a declarative (labeling) function, as a form of cognitive rehearsal, and as a means of self-regulation.” While echolalia may not be a socially appropriate response in all situations, and its meaning may not be understood by all listeners, it often is an important part of communication and should be respected. Treatment is usually centered not on extinction but on improvement of functional use and overall communication. Behavioral therapy, often today as ABA or applied behavioral analysis therapy, is used to assist patients to increase functional skills and interactions. There are speech-therapy techniques which can be used within this framework to assist patients with their functional communication needs. ABA is not the only treatment, one other example is Gestalt Language Processing.

Patients with other neurodivergent diagnoses than autism may have echolalia. Patients who may be neurotypical, but exposed to many hours of language through computers and not through human interaction, may also have atypical speech development which may include echolalia.

Questions for Further Discussion
1. What are indications for referral to a speech-pathologist? A review can be found here
2. What are stereotypies? A review can be found here
3. At what age are articulation problems not considered normal? A review can be found here

Related Cases

Disease: Echolalia | Speech and Communication Disorders

Symptom/Presentation: Infections | Developmental Delay

Specialty: Developmental Disabilities | Speech and Hearing

Age: Preschooler

To Learn More
To view pediatric review articles on this topic from the past year check PubMed.

Evidence-based medicine information on this topic can be found at Cochrane Database of Systematic Reviews. Information prescriptions for patients can be found at MedlinePlus for these topics: Speech and Language Problems in Children and Autism Spectrum Disorders.

To view current news articles on this topic check Google News.

To view images related to this topic check Google Images.

To view videos related to this topic check YouTube Videos.

Stiegler LN. Examining the Echolalia Literature: Where Do Speech-Language Pathologists Stand? Am J Speech Lang Pathol. 2015;24(4):750-762. doi:10.1044/2015_AJSLP-14-0166

Kaufmann C, Agalawatta N, Malhi GS. Catatonia: Stereotypies, mannerisms and perseverations. Aust N Z J Psychiatry. 2018;52(4):391-393. doi:10.1177/0004867418765669

Gladfelter A, VanZuiden C. The Influence of Language Context on Repetitive Speech Use in Children With Autism Spectrum Disorder. Am J Speech Lang Pathol. 2020;29(1):327-334. doi:10.1044/2019_AJSLP-19-00003

Dinello A, Gladfelter A. Intervention Techniques Targeting Echolalia: A Scoping Review. Am J Speech Lang Pathol. 2025;34(3):1528-1543. doi:10.1044/2025_AJSLP-24-00211

Author
Donna M. D’Alessandro, MD
Professor of Pediatrics, University of Iowa

Patient Presentation
A 16-year-old male came to clinic for his health supervision visit. He had noticed two small masses on the left scrotal skin. He had noticed them in the shower about a month previously. They were not changing in size or texture, were not painful, red nor swollen. He denied any obvious trauma, and hadn’t changed any soaps/detergents or hygiene products. He hadn’t been exposed to any plants. He also denied any specific restrictive clothing, except he wore cotton boxer brief-style underwear.

The past medical history was positive for mild acne vulgaris on his face and upper chest that was treated with benzoyl peroxide. He also had some folliculitis on his right upper thigh in the past year that was treated with mupirocin.

The pertinent physical exam showed a healthy teenager with normal vital signs and growth. His genitourinary examination showed 2 yellow-flesh colored nodules on his left scrotum near the thigh, that were approximately 5-8 mm in size without a punctum or erythema, or pain, and they were mobile. There were no other obvious lesions on dermatological examination. The surrounding skin appeared healthy. There were no masses on the testicles or phallus.

The diagnosis was unclear to the pediatrician. Although the nodules appeared benign, she was not sure what they were. “They look like some type of keratin inclusion cyst to me, but they are a little bigger and this is a different location than I usually see these,” she explained to the teenager and parents. A dermatologist, through an asynchronous electronic consultation thought that it was likely a syringoma or steatocytoma multiplex, and later made the diagnosis of steatocytoma multiplex during a subsequent office visit. The patient was treated by monitoring.

Discussion
Skin disorders or variations are one of the most common reasons for visiting a health care provider. Even from birth there are multiple different variations of differences in skin. As the skin is the largest organ and readily visible, patients have concerns that skin changes may be the presenting symptom of a systemic illness. The skin is also one of the major protective factors for the body and therefore the normal wear and tear and exposure of the skin can cause a range of different skin problems that may need treatment.

The differential diagnosis of small skin nodules similar to steatocytoma multiplex includes:

• Acne vulgaris
• Acne conglobata
• Adenoma, sebaceous
• Dermoid or epidermoid cysts
• Follicular infundibular tumors
• Hidradenitis suppurativa
• Lipoma
• Milia
• Sebaceous hyperplasia

Learning Point
For Images – see To Learn More below

• Steatocytoma multiplex (SM)
  • Pilosebaceous gland disorder
  • Presents with asymptomatic, multiple, sebum containing, dermal cysts that are yellow or flesh colored, and has freely moving papules/nodules. There is a variation where there is some inflammation called SM suppurativa which has risk of infection and scarring. Steatocytoma simplex is a solidary lesion.
  • No malignant potential
  • Occurs in mainly 2nd and 3rd decade but can occur in any age group
  • Most cases are sporadic but there is an autosomal dominant form
  • Locations where pilosebaceous glands are prominent – arms, axilla, face, scalp, thighs, trunk, and less commonly breasts and genitals
  • Numerous lesions can occur over time and currently there is no preventative treatment
  • Treatment includes education and monitoring, laser, needle aspiration, cryotherapy, tretinoin cream
• Syringoma
  • Adnexal tumor of the (presumably) eccrine sweat gland (presumably)
  • Asymptomatic, multiple, yellow or flesh-colored papules that can be hyperpigmented, often 1-3 mm in size but can be larger, and can occur in groupings or have solitary lesions.
  • No malignant potential
  • Occurs in mainly 2nd and 3rd decade but can occur in any age group
  • Most cases are sporadic but there is an autosomal dominant form
  • Locations face (especially upper cheeks and lower eyelids), axilla, neck, chest, umbilicus and genitals
  • Treatment includes education and monitoring, atropine sulfate, tretinoin cream, cryotherapy, excision

Questions for Further Discussion
1. What are the worrisome ABCs of skin lesions? A review can be found here
2. What are epidermal cysts? A review can be found here
3. How is hidradenitis suppurativa treated? A review can be found here

Related Cases

Disease: Steatocytoma multiplex | Benign Tumors | Skin Diseases

Symptom/Presentation: Mass or Swelling

Specialty: Dermatology

Age: Teenager

To Learn More

To view pediatric review articles on this topic from the past year check PubMed.

Evidence-based medicine information on this topic can be found at SearchingPediatrics.com and the Cochrane Database of Systematic Reviews. Information prescriptions for patients can be found at MedlinePlus for these topics: Benign Tumors and Skin Conditions.

To view current news articles on this topic check Google News.

To view images related to this topic check Google Images – Syringoma.

To view images related to this topic check Google Images – Steatocytoma multiplex.

To view videos related to this topic check YouTube Videos.

Petersson F, Mjornberg PA, Kazakov DV, Bisceglia M. Eruptive Syringoma of the Penis. A Report of 2 Cases and a Review of the Literature. The American Journal of Dermatopathology. 2009;31(5):436. doi:10.1097/DAD.0b013e3181930d93

Varshney A, Aziz M, Maheshwari V, et.al. Steatocystoma multiplex – PMC. Accessed July 28, 2025. https://pmc-ncbi-nlm-nih-gov.proxy.lib.uiowa.edu/articles/PMC3185371/

Georgakopoulos JR, Ighani A, Yeung J. Numerous asymptomatic dermal cysts: Diagnosis and treatment of steatocystoma multiplex. Can Fam Physician. 2018;64(12):892-899.

Singh A, Oakley A. Syringoma. DermNet®. October 26, 2023. Accessed August 5, 2025. https://dermnetnz.org/topics/syringoma

Author
Donna M. D’Alessandro, MD
Professor of Pediatrics, University of Iowa

Patient Presentation
An almost 18-year-old female came to clinic ostensibly for weight management with approval from her parent. She said she did little exercise preferring to play video games, and continued to have poor nutritional intake. “I just want the shot. My aunt started on them and she’s lost a lot of weight. I just want to do that too,” she said.

The past medical history showed her to have increasing weight over the past few years with a body mass index (BMI) of 28.6 kg/M the previous year. Appropriate nutrition and activity and healthy lifestyles had been discussed over several years and followup appointments including referral to the cardiometabolic clinic had not been kept. Her lab testing the previous year showed mildly elevated liver function tests, low HDL and elevated LDL on lipid testing, and an HgbA1c of 5.9 %. Her thyroid testing was normal.

The family history was positive for obesity, type 2 diabetes, and heart disease. The review of systems revealed that she endorsed tiredness with additional exercise, no problems with sleeping, headache, abdominal pain, or joint problems.

The pertinent physical exam had a heart rate of 84, blood pressure of 118/76, with normal respirations and temperature. Her height was 165 cm, weight 80.8 kg with a BMI of 29.7 kg/M. She had no evidence of acanthosis nigricans, but had striae. Her thyroid was normal, heart was without murmurs and lungs were clear. Her abdomen was obese making it difficult to tell if there was any organomegaly. The rest of her examination was normal.

The diagnosis of continued elevation in body mass and serious obesity. The pediatrician discussed healthy lifestyle again along with referral to the cardiometabolic clinic for weight management including possible medication management. The adolescent asked, “Aren’t you going to give me the shots?” and when the pediatrician said that he would not be, the adolescent said “I just want the shots and I’m not going to do any exercise, or do anything else.” The pediatrician tried to re-engage with the adolescent, but she would not re-engage. As she left, he reminded her of her health maintenance visit that was due in 4 months and the issue could be discussed at that time as well.

Discussion
Overweight and obesity are health problems that are increasing with a 1 in 5 prevalence of pediatric obesity. Data from 2017-20 estimated that 19.7% of US children were obese, and “[o]ne study estimated that about 57% of the population of US children in 2016 would live with obesity by the time they were aged 35 years.” Multiple studies have shown that overweight and obese children have a high likelihood of becoming obese adults. They are more likely to have “type 2 diabetes mellitus…, hypertension, hyperlipidemia, metabolic-dysfunction-associated steatotic liver disease…., and obstructive sleep apnea, among other conditions.” Pediatric and adolescent mental health can also be affected with “…increased risk of anxiety, depression, social isolation, and peer victimization.””

Obesity management takes a multidisciplinary approach including nutritional counseling, increased activity, mental health support, and potential medication and surgical interventions (i.e. bariatric surgery). Glucagon-like peptide-1 receptor agonists (GLP-1s) are similar to a type of gut-derived hormone which help with regulating metabolism though “…increased insulin secretion and sensitivity to delayed gastric emptying and promotion of postprandial satiety.” GLP-1s (e.g. exenatide, dulaglutide, liraglutide, tirzepatide, semalutide) were approved for type 2 diabetes for about 20 years, and for weight management for about 10 years. Semaglutide (Wegovy® Ozempic®) was approved for adults in 2017 for type 2 diabetes, in 2021 for weight management and for lowering the risks of cardiovascular problems in 2024. GLP-1 cost can be significant ranging $500-1600/month depending on the medication, dose and potential insurance coverage.

Learning Point
The use of GLP-1s is quickly and significantly expanding in the adult population and already changes are seen in the adolescent and young adult populations.

One 2024 study found that dispensing of GLP-1s significantly increased from 2020-2024 for adolescents and young adults ages 12-25 years. For adolescents (12-17 years) the number of prescriptions is substantially lower (N=30,947) than for young adults (18-25 years, N=162,439). About 46% of the prescriptions were dispensed in the US South, and the last GLP-1 dispensed was most commonly semaglutide. For both groups the most common prescribers were endocrinologists, nurse practitioners and family medicine physicians. Pediatricians prescribed 3415 prescriptions for adolescents and 2067 for young adults, or ~2.8% of all prescriptions. The American Academy of Pediatrics State of the Art Review noted that “[GLP-1] are relatively new and expensive, and initiating treatment typically requires subspecialty and/or multidisciplinary care.”

A 2021 meta-analysis for children and adolescents < 18 years found that GLP-1s were "...safe and effective in modestly reducing weight, BMI and glycated hemoglobin A1c, and systolic blood pressure in children and adolescents with obesity in a clinical setting...." Nausea was a common side effect. Lifestyle interventions amplified the weight-reducing effects of GLP-1s in the pediatric age group.

Currently Federal Drug Administration approved GLP-1s in pediatric age range are liraglutide injected daily for patients 10 years and older for type 2 diabetes since 2019, with generic approval in 2024. It is also used for patients 12 years and older for severe obesity since 2020 with a BMI of > 30 kg/M and weight more than 60 kg. Semaglutide, as Wegovy®, is injected weekly and was approved for patients 12 years and older for obesity in 2022.

Because of the GLP-1 use expansion and significant costs, the FDA recently is warning about unapproved GLP-1s being used for weight loss.

Questions for Further Discussion
1. What are your current practices and planned future practices for GLP1s?
2. What are indications for use of metformin? A review can be found here
3. How do you manage other obesity-related problems such as hypertension?

Related Cases

Disease: Obesity

Symptom/Presentation: Obesity

Specialty: Endocrinology | General Pediatrics | Pharmacology / Toxicology

Age: Teenager

To Learn More
To view pediatric review articles on this topic from the past year check PubMed.

Evidence-based medicine information on this topic can be found at SearchingPediatrics.com and the Cochrane Database of Systematic Reviews. Information prescriptions for patients can be found at MedlinePlus for this topic: Obesity

To view current news articles on this topic check Google News.

To view images related to this topic check Google Images.

To view videos related to this topic check YouTube Videos.

FDA approves weight management drug for patients aged 12 and older. December 4, 2020. Accessed August 4, 2025. https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-weight-management-drug-patients-aged-12-and-older

Ryan PM, Seltzer S, Hayward NE, Rodriguez DA, Sless RT, Hawkes CP. Safety and Efficacy of Glucagon-Like Peptide-1 Receptor Agonists in Children and Adolescents with Obesity: A Meta-Analysis. J Pediatr. 2021;236:137-147.e13. doi:10.1016/j.jpeds.2021.05.009

Cardiometabolic Health Congress. In the first big pharmaceutical development of 2023, Novo Nordisk announced that the U.S. Food and Drug Administration (FDA) has approved an expanded indication for semaglutide as the first injectable antiobesity prescription medication for use in pediatric patients. January 6, 2023. Accessed August 4, 2025. https://www.cardiometabolichealth.org/article/fda-approves-semaglutide-for-pediatric-patients/

Lee JM, Sharifi M, Oshman L, Griauzde DH, Chua KP. Dispensing of Glucagon-Like Peptide-1 Receptor Agonists to Adolescents and Young Adults, 2020-2023. JAMA. 2024;331(23):2041-2043. doi:10.1001/jama.2024.7112

Commissioner of the FDA Approves First Generic of Once-Daily GLP-1 Injection to Lower Blood Sugar in Patients with Type 2 Diabetes. FDA. December 27, 2024. Accessed August 4, 2025. https://www.fda.gov/news-events/press-announcements/fda-approves-first-generic-once-daily-glp-1-injection-lower-blood-sugar-patients-type-2-diabetes

Stefater-Richards MA, Jhe G, Zhang YJ. GLP-1 Receptor Agonists in Pediatric and Adolescent Obesity. Pediatrics. 2025;155(4):e2024068119. doi:10.1542/peds.2024-068119

Author
Donna M. D’Alessandro, MD
Professor of Pediatrics, University of Iowa

Patient Presentation
A pediatrician was reviewing the chart of a 26-month old female who had been seen at a local urgent care for sore throat. The patient has been empirically treated with antibiotics based on history and physical examination. The urgent care clinician also cited a modified Centor criteria as justification for starting the empiric antibiotics. She discussed this issue with one of her partners who had noted a similar practice pattern. They identified that it was a new urgent care clinician who had started empiric antibiotics twice. The pediatrician sent a professional e-mail to the urgent care physician providing information that the use of the modified Centor criteria was not appropriate in the < 3 year old age group, and providing a reference to the clinical guidelines. The urgent care provider's reply thanked the pediatrician for the guidance.

Discussion
Group A streptococcal pharyngitis (GAS) is the most common bacterial cause of pharyngitis world-wide. Not only can it cause localized disease, but it can cause invasive disease such as necrotizing fasciitis, pneumonia, and toxic shock syndrome. In children 3 years and older it can cause potential immunological complications such as rheumatic heart disease. GAS is most common in ages 5-15 years, and occurs often in temperate climates, with the highest incidence in winter and early spring.

While GAS is common, its evaluation and management are not simple.

History and physical examination findings cannot adequately discern GAS from the even more common viral causes of infectious pharyngitis (e.g. adenovirus, coxsackie, Epstein-Barr virus, influenza, rhinovirus, etc.) as there is significant overlap. “There needs to be more clarity in the literature regarding the clinical signs and symptoms of viral and bacterial pharyngitis. Symptoms, such as severe sore throat, sudden onset of fever, chills, malaise, nausea, vomiting, abdominal pain, myalgia, headache, tonsillar discharge, tonsillar hypertrophy, tender-enlarged anterior cervical lymphadenopathy, absence of cough, palatal petechia, strawberry tongue, scarlatiniform rash, and uvula edema may be observed in streptococcal infections….Although the presence of cough, runny nose, congestion, hoarseness, mouth ulcers, conjunctivitis, and diarrhea are more suggestive of a viral infection, the clinical symptoms seen in streptococcal infections can also be seen in viral infections.”

A throat culture is the gold standard for diagnosis but can take 1-2 days before results are available, and testing may be limited in some locations. Rapid antigen detection tests (RADT) can be completed in the office and are quick to perform. Cost can still be a problem in resource limited areas.

Learning Point
The appropriate use of RADT along with clinical decision support algorithms and clinical practice guidelines can help clinicians make good decisions regarding patient care. They do need to be applied to the appropriate patient population.

The Centor criteria and McIssac criteria (MCC) are two clinical decision support tests which can be used to help a clinician. Centor scores for patients > 15 years and MCC for patients > 3 years were validated by Fine et. al. The Infectious Disease Society of America (IDSA)has clinical practice guidelines for clinical use.

• Centor criteria (1 point for each criteria present, range is 0-4 points)
  • Exudate or swelling of tonsils
  • Swollen/tender anterior cervical lymph nodes
  • Fever
  • Absent cough
• Modified McIssac criteria (modified Centor criteria or MCC, range 0-5 points). The following is added to the Centor criteria
  • Ages 3-14 years = +1 point
  • Ages 15-44 years = 0 point
  • Ages > and = 45 years = -1 point

In general, scores of 0-1 do not recommend additional testing or treatment, a score of 2 and a clinician may consider testing, and scores of 3 or more suggest testing would be indicated.

Children under 3 years are less likely to have GAS and also the immunological sequelae or rheumatic heart disease are rare. They also are more likely GAS carriers and may test falsely-positive. The Centor and MCC were not developed, nor validated, for this age group. Testing is not recommended for this age group, but testing may be considered if there is a close contact such as a sibling or close day-care contact who is positive for GAS.

Children and youth 5-15 years are at highest risk for GAS. The Centor and MCC can be applied for children 3 years and older as the tests are validated in this age group. Children, youth and adults with overt viral symptoms such as presence of cough, rhinorrhea, hoarseness and oralpharyngeal ulcers are usually not recommended to be tested.

All pediatric patients should have a positive RADT and/or culture for GAS before antibiotics are prescribed, as history and physical examination are unreliable indicators of GAS. Positive RADTs do not need a confirmatory throat culture. Negative RADTs do need a confirmatory culture in children and adolescents, but not adults as the incidence of GAS in the adult population is low and sequelae risk is very low in adults.

Appropriate antibiotics should be prescribed that can eradicate the GAS. Penicillin or amoxicillin for 10 days is the common choice. For allergic individuals “…a first generation cephalosporin …for 10 days, or clindamycin or clarithromycin for 10 days, or azithromycin for 5 days.” The IDSA guidelines has a discussion about empiric treatment in adult patients which balances the risk of over- and under-treatment. They state “…exclusion of the diagnosis [of GAS] on the basis of negative RADT results without confirmation by negative culture results is an acceptable alternative to diagnosis….The generally high specificity of RADT should minimize overprescription of antimicrobials for treatment of adults.”

Questions for Further Discussion
1. What causes pharyngitis? A review can be found here
2. How is invasive streptococcal disease treated?
3. What are the common serotypes for Group B streptococcus? A review can be found here

Related Cases

Disease: Streptococcal Infections | Throat Disorders

Symptom/Presentation: Infections | Sore Throat

Specialty:Infectious Diseases | Pathology

Age: Toddler

To Learn More
To view pediatric review articles on this topic from the past year check PubMed.

Evidence-based medicine information on this topic can be found at SearchingPediatrics.com and the Cochrane Database of Systematic Reviews. Information prescriptions for patients can be found at MedlinePlus for these topics: Streptococcal Infections and Strep Throat.

To view current news articles on this topic check Google News.

To view images related to this topic check Google Images.

To view videos related to this topic check YouTube Videos.

Shulman ST, Bisno AL, Clegg HW, et al. Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2012;55(10):e86-e102. doi:10.1093/cid/cis629

Fine AM, Nizet V, Mandl KD. Large-Scale Validation of the Centor and McIsaac Scores to Predict Group A Streptococcal Pharyngitis. Arch Intern Med. 2012;172(11):847-852. doi:10.1001/archinternmed.2012.950

Jaaskelainen J, Renko M, Kuitunen I. Centor scores associated poorly with rapid antigen test findings in children with sore throat. Eur J Pediatr. 2024;184(1):4. doi:10.1007/s00431-024-05863-2

Haynes MA, Temkit M, Kushner I, Hindman DE. Appropriateness of Use of Streptococcal Pharyngitis Testing and Associated Antibiotic Prescribing in the Urgent Care Setting. Clin Pediatr (Phila). 2024;63(12):1691-1697. doi:10.1177/00099228241237908

Eroglu A, Suzan OK, Kolukısa T, et al. The relationship between group A streptococcus test positivity and clinical findings in tonsillopharyngitis in children: systematic review and meta-analysis. Infection. 2025;53(1):427-436. doi:10.1007/s15010-024-02395-7

Leung AKC, Lam JM, Barankin B, Leong KF, Hon KL. Group A beta-hemolytic Streptococcal Pharyngitis: An Updated Review. Curr Pediatr Rev. 2024;21(1):2-17. doi:10.2174/1573396320666230726145436

Author
Donna M. D’Alessandro, MD