feverPAIN criteria

Last edited 07/2018 and last reviewed 12/2022

FeverPAIN criteria

  • Fever (during previous 24 hours)

  • Purulence (pus on tonsils)

  • Attend rapidly (within 3 days after onset of symptoms)

  • Severely Inflamed tonsils

  • No cough or coryza (inflammation of mucus membranes in the nose)

Each of the FeverPAIN criteria score 1 point (maximum score of 5)

  • Higher scores suggest more severe symptoms and likely bacterial (streptococcal) cause

    • A score of 0 or 1 is thought to be associated with a 13 to 18% likelihood of isolating streptococcus

    • A score of 2 or 3 is thought to be associated with a 34 to 40% likelihood of isolating streptococcus

    • A score of 4 or 5 is thought to be associated with a 62 to 65% likelihood of isolating streptococcus

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