The Clinical Presentation of Fusobacterium-Positive and Streptococcal-Positive Pharyngitis in a University Health Clinic: A Cross-sectional Study
RM Centor, TP Atkinson, AE Ratliff, L Xiao… - Annals of internal …, 2015 - acpjournals.org
RM Centor, TP Atkinson, AE Ratliff, L Xiao, DM Crabb, CA Estrada, MB Faircloth, L Oestreich…
Annals of internal medicine, 2015•acpjournals.orgBackground: 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 US data exist.
Objective: 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 …
infection. European data suggest that in patients aged 15 to 30 years, Fusobacterium
necrophorum causes at least 10% of cases of pharyngitis; however, few US data exist.
Objective: 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 …
Background
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.
Objective
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.
Design
Cross-sectional.
Setting
University student health clinic.
Patients
312 students aged 15 to 30 years presenting to a student health clinic with an acute sore throat and 180 asymptomatic students.
Measurements
Polymerase chain reaction testing from throat swabs to detect 4 species of bacteria and signs and symptoms used to calculate the Centor score.
Results
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).
Limitations
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.
Conclusion
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.
Primary Funding Source
University of Alabama at Birmingham and the Justin E. Rodgers Foundation.
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