Version June 2024
| Clinical syndrome | Clinical clues | |
| Bacteria (requires antimicrobial therapy) | ||
| Streptococcus, group A (most common cause requiring antimicrobial therapy) | Tonsillopharyngitis and scarlet fever | Acute onset, fever, headache, abdominal pain, tonsillopharyngeal erythema and exudate, tender anterior cervical lymph nodes |
| Streptococcus, groups C and G | Tonsillopharyngitis and scarlatiniform rash | |
| Neisseria gonorrhoeae | Pharyngitis | Oral-genital contact in sexually active adolescents |
| Fusobacterium necrophorum | Jugular vein suppurative thrombophlebitis (Lemierre syndrome) | Primarily affects adolescents and young adults, high fever (>39°C [102.2°F]), rigors respiratory symptoms, unilateral neck swelling or pain |
| Arcanobacterium haemolyticum | Pharyngitis and scarlatiniform rash | More common in adolescents, rash occurs in approximately one-half |
| Corynebacterium diphtheriae | Diphtheria | Tightly adherent membrane in nose and throat, history of travel (particularly to former Soviet Union, Africa, or Asia), lack of immunizations |
| Tularemia | Ulcerative-exudative pharyngitis | Ingestion of poorly cooked wild animal meat or contaminated water |
| Atypical bacteria (may require specific therapy or infection control measures) | ||
| Mycoplasma pneumoniae | Pneumonia, bronchitis, and pharyngitis | Adolescents and adults |
| Viruses that infect the pharynx directly | ||
| Epstein-Barr virus (EBV) | Infectious mononucleosis | Fever, severe pharyngitis, frequent exudates, anterior and posterior cervical lymphadenopathy, prominent constitutional symptoms |
| Cytomegalovirus (CMV) | Infectious mononucleosis | Fever, mild or no pharyngitis, anterior and posterior cervical lymphadenopathy, prominent constitutional symptoms |
| Human immunodeficiency virus (HIV) | Primary HIV infection | Mononucleosis-like syndrome with fever, weight loss, diffuse adenopathy, rash, splenomegaly, lymphopenia |
| Herpes simplex virus types 1 and 2 | Pharyngitis | Exudative or nonexudative tonsillopharyngitis in sexually active adolescents, ulcerative lip lesion in 10 to 40 percent of cases |
| Influenza A and B viruses | Influenza | Fever, cough, pharyngitis, headache, myalgia, seasonal epidemics |
| Enteroviruses (Coxsackie A) | Herpangina and hand-foot-and-mouth disease | Vesicles in posterior pharynx may be accompanied by lesions on hands and feet |
| Adenovirus | Pharyngoconjunctival fever and acute respiratory disease | Conjunctivitis, tonsillopharyngeal erythema and exudates |
| Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)* | Pharyngitis COVID-19 MIS-C | Clinical features are variable; may include fever, persistent cough, shortness of breath, gastrointestinal symptoms, cutaneous findings, epidemiologic link to individuals with SARS-CoV-2 infection |
| Viruses that cause nasopharyngitis (generally do not require specific therapy or infection control measures) | ||
| Rhinovirus | Common cold | Nasal symptoms predominate |
| Coronaviruses, including SARS-CoV-2* | Common cold | Nasal symptoms predominate |
| Respiratory syncytial virus | Bronchiolitis, common cold | Nasal symptoms predominate, seasonal epidemics |
| Parainfluenza | Common cold, croup | Stridor, hoarseness, prominent nasal symptoms |
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