F — Fever (Temperature ≥38°C / 100.4°F in Past 24 Hours)

No — Afebrile or temperature <38°C in past 24 hours+0Yes — Fever ≥38°C (100.4°F) reported or measured in past 24 hours+1

P — Purulence (Purulent Tonsils / Tonsillar Exudate)

No — No tonsillar exudate or purulence visible+0Yes — Purulent exudate visible on tonsils+1

A — Attend Rapidly (Symptom Onset ≤3 Days Before Presentation)

No — Symptoms began more than 3 days ago+0Yes — Symptom onset within the past 3 days (≤3 days)+1

I — Inflamed Tonsils (Severe Tonsil Inflammation)

No — No or only mild-to-moderate tonsillar inflammation+0Yes — Severely inflamed tonsils (marked erythema and enlargement)+1

N — No Cough or Coryza (Absence of Both)

No — Cough or coryza (rhinorrhea) present → more likely viral+0Yes — No cough AND no coryza present+1

FeverPAIN Score for Streptococcal Pharyngitis