Which physical exam finding is most associated with streptococcal pharyngitis?

The physical exam finding most associated with streptococcal pharyngitis is pharyngeal erythema. This condition, often caused by the Group A Streptococcus bacteria, typically manifests with significant redness and swelling in the throat, which is a hallmark indicator of the infection. The inflammation presents as diffuse erythema of the pharynx and the tonsils, sometimes accompanied by exudates or patches that suggest a bacterial etiology rather than a viral infection.

In contrast, other findings, while potentially present in throat infections, are either less specific or more indicative of different conditions. Tonsillar shrinkage generally suggests recovery or a non-infectious cause. Clear nasal discharge is more commonly associated with viral upper respiratory infections rather than streptococcal infections, which do not typically cause significant nasal symptoms. Cervical lymphadenopathy can occur in various infections, not just streptococcal pharyngitis; while swollen lymph nodes can be a sign of streptococcal infection, the prominent feature most directly linked to streptococcal pharyngitis is the intense redness of the pharynx.