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  Clinical Calculators - Centor Criteria (Modified)  

The Centor Criteria1 are a set of criteria which may be used to identify the likelihood of a bacterial infection in adult patients complaining of a sore throat. They were developed as a method to quickly diagnose the presence of Group A streptococcal infection or a diagnosis of Streptococcal Pharyngitis in "adult patients who presented to an urban emergency room complaining of a sore throat." The Modified Centor Criteria2 takes account of the patient's age.

You must give information about all five assessments - fever, tonsillar exudate, tender anterior cervical adenopathy, cough and age - in order to determine a Centor score for this patient.

  Tonsillar exudates:      
  Tender anterior cervical adenopathy:      
  Absence of cough:      
    < 15 years  
    15-44 years  
    > 44 years  

  The presence of all four variables indicates a 40 - 60% positive predictive value for a culture of the throat to test positive for Group A Streptococcus bacteria. The absence of all four variables indicates a negative predictive value of greater than 80%3. The high negative predictive value suggests that the Centor Criteria can be more effectively used for ruling out streptococcal throat infection than for diagnosing streptococcal throat infection.  


  1. Centor RM, Witherspoon JM, Dalton HP, Brody CE & Link K (1981). "The diagnosis of Streptococcal throat infection in adults in the emergency room". Medical Decision Making 1 (3): 239–246.
  2. McIsaac WJ, Kellner JD, Aufricht P, Vanjaka A & Low DE (7 April 2004). "Empirical Validation of Guidelines for the Management of Pharyngitis in Children and Adults". Journal of the American Medical Association 291 (13): 1587–1595.
  3. Marín Cañada J, Cubillo Serna A, Gómez-Escalonilla Cruz N, Garzón de la Iglesia J, Benito Ortiz L, Reyes Fernández MN (July 2007). "Is streptococcal pharyngitis diagnosis possible?". Aten Primaria (in Spanish) 39 (7): 361–365.


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Last Update: 31 January 2008