The aetiology of pharyngotonsillitis in adolescents and adults - Fusobacterium necrophorum is commonly found (original) (raw)
Related papers
Annals of Internal Medicine, 2015
Background: Pharyngitis guidelines focus solely on group A -hemolytic streptococcal infection. European data suggest that in patients aged 15 to 30 years, Fusobacterium necrophorum causes at least 10% of cases of pharyngitis; however, few U.S. data exist. Objective: To estimate the prevalence of F. necrophorum; Mycoplasma pneumoniae; and group A and C/G -hemolytic streptococcal pharyngitis and to determine whether F. necrophorum pharyngitis clinically resembles group A -hemolytic streptococcal pharyngitis.
Family Practice, 2001
Gunnarsson RK, Holm SE and Söderström M. The prevalence of potential pathogenic bacteria in nasopharyngeal samples from individuals with a respiratory tract infection and a sore throat-implications for the diagnosis of pharyngotonsillitis. Family Practice 2001; 18: 266-271. Background. Treatment failure in patients with pharyngotonsillitis after a traditional course of penicillin V is a common finding. Several factors have been proposed to explain the failure rate, but the presence of aetiological agents other than group A β-haemolytic streptococci has attracted little attention. Objectives. The aim of the present study was to investigate if a nasopharyngeal sample could suggest the aetiology of a sore throat in patients with a respiratory tract infection. Methods. The prevalence of potentially pathogenic bacteria (Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis) in nasopharyngeal samples from 618 healthy individuals was compared with that from 108 patients with a respiratory tract infection and a sore throat. Results. The prevalence of H.influenzae was higher in patients with a sore throat than in healthy individuals of the same age. For the adult patients with a sore throat, the prevalence was 27.5% compared with 2.7% for the healthy carriers (P Ͻ 10-7). The corresponding figures for schoolchildren were 31.3% versus 6.1% (P = 0.004) and for preschool children 37.8% versus 13.2% (P = 0.0003). Conclusions. If H.influenzae is found in a nasopharyngeal sample from a patient with a respiratory tract infection and a sore throat, it might be the aetiological agent.
VIRAL AND BACTERIAL PHARYNGOTONSILITIS: DIFFERENTIAL CLINICAL ASPECTS ( Atena Editora)
VIRAL AND BACTERIAL PHARYNGOTONSILITIS: DIFFERENTIAL CLINICAL ASPECTS ( Atena Editora), 2022
Acute pharyngotonsillitis (FT) is defined as an infection of the pharynx and/or tonsils that can be caused by a range of pathogens. When the infection is viral, there is no specific treatment. Because it is a self-limiting disease in 5 to 7 days and has a good prognosis in previously healthy children, general measures are more indicated in these cases: hydration, symptoms for pain and/or fever, preventive measures and observation. However, although most bacterial infections are also benign and self-limiting, a small number of patients infected with some strains of hemolytic beta group A Streptococcus can complicate matters. Given this risk, early treatment with antibiotics is well indicated. Despite this, the abusive use of antibiotics has globally worried health authorities. Therefore, the current study aims to demystify differential clinical aspects of the manifestation of TF in order to improve medical accuracy in choosing the most appropriate treatment. METHODOLOGY: This is a literature review initiated from the selection of the main etiological agents for pharyngotonsillitis based on the incidence in scientific literature of its different types (viral or bacterial). Among the inclusion criteria, studies with description of clinical history and/or physical examination for the disease were selected. Finally, a literature review of the main data related to. RESULTS: The age group does not exclude the possibility, but it confirms it as a favorable factor for differentiation. In children under 3 years of age, the incidence of viral infections is much higher than that of bacterial origin. Children with viral infections also manifest more extra-pharyngeal symptoms, such as nasal discharge, conjunctivitis, cough, hoarseness, diarrhea, ulcerations, or others. In addition, high fever, sudden onset, intense odynophagia, petechiae on the palate, and cervical adenopathy that is painful on palpation are more frequently associated with bacterial infection. Currently, one of the most used clinical tools to indicate the possibility of the etiologic agent and, consequently, the need for treatment with antibiotic therapy, is the McIsaac Modified Centor Score. CONCLUSIONS: The difference in management makes a thorough clinical diagnosis important, despite the recommendation to use complementary exams, to avoid the irrational use of antibiotics - which already represents a situation of global alert. Finally, literature review studies such as this one allow to support medical practice with more illustrative and objective information, whose expected result involves the improvement of the clinical diagnosis and, finally, the more accurate and rational prescription of antibiotics in cases of TF.
BMC Infectious Diseases, 2021
Background: Diagnosis and treatment of pharyngotonsillitis are commonly focused on group A streptococci (GAS), although the disease is often associated with other pathogens. While the incidence of pharyngotonsillitis is known to vary with season, seasonal variations in the prevalence of potential pathogens are sparsely explored. The aim of this study was to explore any seasonal variations in the use and outcome of rapid antigen detection tests (RADTs) for GAS and throat cultures among patients diagnosed with pharyngotonsillitis in primary care. Methods: We retrieved and combined retrospective data from the electronic medical record system and the laboratory information system in Kronoberg County, Sweden. Primary care visits resulting in a diagnosis of tonsillitis or pharyngitis were included, covering the period 2013-2016. The monthly rate of visits was measured, along with the use and outcome of RADTs for GAS and throat cultures obtained on the date of diagnosis. The variations between calendar months were then analysed. Results: We found variations between calendar months, not only in the mean rate of visits resulting in a diagnosis of pharyngotonsillitis (p < 0.001), but in the mean proportion of RADTs being positive for GAS among the diagnosed (p < 0.001), and in the mean proportion of visits associated with a throat culture (p < 0.001). A lower mean rate of visits in August and September coincided with a lower proportion of RADTs being positive for GAS among them, which correlated with a higher proportion of visits associated with a throat culture. Conclusions: This study suggests that the role of GAS in pharyngotonsillitis in Sweden is less prominent in August and September than during the rest of the year.
A Case of Embolic Spread of Fusobacterium necrophorum From Presumed Pharyngitis
Cureus, 2021
Fusobacterium necrophorum is the most common pathogen isolated in individuals diagnosed with the rare and life-threatening illness known as Lemierre's syndrome. Lemierre's syndrome commonly involves a triad of infection in the oropharyngeal region, thrombophlebitis of the internal jugular vein, and distant metastases of said infection. Our case involves an embolic spread of F. necrophorum to the lungs, which was presumed to have originated in the pharynx, in the absence of internal jugular vein thrombosis. The clinical course of the patient was further complicated by an initial diagnosis of community-acquired pneumonia, severe sepsis, and disseminated intravascular coagulation. After suitable input from the multidisciplinary team and adequate antibiotic therapy, the patient demonstrated a positive outcome with complete recovery to her baseline.
Fusobacterium necrophorum Septicemia Following Oropharyngeal Infection
JAMA: The Journal of the American Medical Association, 1982
The present study included 50 untreated malaria patients attending the Outpatient Department at Dhiraj General Hospital, Sumandeep Vidyapeeth, Piparia, with symptoms of fever, rigor, headache and vomiting between June 2013 to December 2013. Patients who tested positive for malaria by slide microscopy were enrolled in the study. In all the patients' malaria infection was the only diagnosis. A finger prick blood sample was taken to prepare thick and thin blood films and stained with Geimsa stain to determine the presence of malaria parasites. The following lab investigations were performed when the patient was admitted:-Percentage parasite count, platelet count,
Revista paulista de pediatria : orgão oficial da Sociedade de Pediatria de São Paulo, 2014
To assess the utility of clinical features for diagnosis of streptococcal pharyngotonsillitis in pediatrics. A total of 335 children aged 1-18 years old and presenting clinical manifestations of acute pharyngotonsillitis (APT) were subjected to clinical interviews, physical examinations, and throat swab specimen collection to perform cultures and latex particle agglutination tests (LPATs) for group A streptococcus (GAS) detection. Signs and symptoms of patients were compared to their throat cultures and LPATs results. A clinical score was designed based on the multivariate logistic regression analysis and also was compared to throat cultures and LPATs results. Positive throat cultures and/ or LPATs results were used as a reference standard to establish definitive streptococcal APT diagnosis. 78 children (23.4%) showed positivity for GAS in at least one of the two diagnostic tests. Coryza absence (odds ratio [OR]=1.80; p=0.040), conjunctivitis absence (OR=2.47; p=0.029), pharyngeal e...
Fusobacterium necrophorum: Most Prevalent Pathogen in Peritonsillar Abscess in Denmark
Clinical Infectious Diseases, 2009
Background. Group A streptococci are commonly regarded as the most prevalent cause of acute bacterial tonsillitis and peritonsillar abscess (PTA). However, the majority of PTA aspirates also contain strains of anaerobes, and accumulating evidence indicates that Fusobacterium necrophorum (FN) could be involved in acute tonsillitis. The purpose of the present study was to describe the epidemiology and bacteriology of PTA in Denmark, with particular emphasis on correlations between microbiological, clinical, and laboratory data.
Aetiology of acute pharyngitis: the role of atypical bacteria
Journal of Medical Microbiology, 2004
In order to establish the role of atypical bacteria and compare characteristics of different infectious agents in acute pharyngitis, 127 patients with acute pharyngitis (66 males; median age, 5.33 years; range, 6 months to 14 years) and 130 healthy subjects of similar sex and age were studied. Serology with paired samples and PCR on nasopharyngeal aspirates and throat cultures were used to identify bacteria and viruses. Viruses were identified in 43 patients (33.8 %) and five controls (3.8 %; P < 0.0001), potential bacterial pathogens in 34 patients (26.8 %) and 26 controls (20 %; P = 0.256) and mixed viral/bacterial pathogens in 26 patients (20.5 %) and none of the controls (P < 0.0001). The main aetiological agents were adenovirus, respiratory syncytial virus (RSV), Mycoplasma pneumoniae, Streptococcus pyogenes and Chlamydia pneumoniae. M. pneumoniae was the agent found most frequently as a single pathogen. A history of recurrent pharyngitis, having older siblings and a nega...