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The Clinical Presentation of Fusobacterium -Positive and Streptococcal-Positive Pharyngitis in a University Health Clinic

2015; American College of Physicians; Volume: 162; Issue: 4 Linguagem: Inglês

10.7326/m14-1305

1539-3704

Robert M. Centor, T. Prescott Atkinson, Amy E. Ratliff, Li Xiao, Donna M. Crabb, Carlos A. Estrada, Michael B. Faircloth, Lisa Oestreich, Jeremy Hatchett, Walid Khalife, Ken B. Waites,

Infective Endocarditis Diagnosis and Management

Pharyngitis guidelines focus solely on group A β-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.To estimate the prevalence of F. necrophorum; Mycoplasma pneumoniae; and group A and C/G β-hemolytic streptococcal pharyngitis and to determine whether F. necrophorum pharyngitis clinically resembles group A β-hemolytic streptococcal pharyngitis.Cross-sectional.University student health clinic.312 students aged 15 to 30 years presenting to a student health clinic with an acute sore throat and 180 asymptomatic students.Polymerase chain reaction testing from throat swabs to detect 4 species of bacteria and signs and symptoms used to calculate the Centor score.Fusobacterium necrophorum was detected in 20.5% of patients and 9.4% of asymptomatic students. Group A β-hemolytic streptococcus was detected in 10.3% of patients and 1.1% of asymptomatic students. Group C/G β-hemolytic streptococcus was detected in 9.0% of patients and 3.9% of asymptomatic students. Mycoplasma pneumoniae was detected in 1.9% of patients and 0 asymptomatic students. Infection rates with F. necrophorum, group A streptococcus, and group C/G streptococcus increased with higher Centor scores (P < 0.001).The study focused on a limited age group and took place at a single institution. Asymptomatic students-rather than seasonal control participants-and a convenience sample were used.Fusobacterium necrophorum-positive pharyngitis occurs more frequently than group A β-hemolytic streptococcal-positive pharyngitis in a student population, and F. necrophorum-positive pharyngitis clinically resembles streptococcal pharyngitis.University of Alabama at Birmingham and the Justin E. Rodgers Foundation.