In taking a history from a patient with a sore throat, the clinician must enquire about the course and duration of illness as well as other associated symptoms such as fever, headache and vomiting. In severe cases, the ability to swallow may be lost and lead to symptoms and signs of dehydration.

Severe pain, neck stiffness or inability to swallow should also prompt the clinician to consider other, more serious, diagnoses such as epiglottitis and retropharyngeal abscess.

Abdominal symptoms such as pain and vomiting are common in children but the presence of gastrointestinal symptoms does not predict the presence of a streptococcal illness [8].

It is important to identify any history suggestive of immunosuppression or compromise e.g. diabetes, HIV or immunosuppressive medications. Patients on disease-modifying anti-rheumatic drug (DMARDs), carbimazole and chemotherapy may develop neutropaenia or agranulocytosis that present with a sore throat. These patients require an urgent Full Blood Count.

The patient must also be asked about previous non-suppurative complications of GABHS infection, as there is an increased risk of both rheumatic fever and post-streptococcal glomerulonephritis with further GABHS infection.