title: The clinical presentation of Fusobacterium-positive and streptococcal-positive pharyngitis in a university health clinic: a cross-sectional study.
abstract: 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.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  University student health clinic.
  
  
  METHODS
  312 students aged 15 to 30 years presenting to a student health clinic with an acute sore throat and 180 asymptomatic students.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  University of Alabama at Birmingham and the Justin E. Rodgers Foundation.
authors: Robert M
authors: RM
authors: Centor
authors: T Prescott
authors: TP
authors: Atkinson
authors: Amy E
authors: AE
authors: Ratliff
authors: Li
authors: L
authors: Xiao
authors: Donna M
authors: DM
authors: Crabb
authors: Carlos A
authors: CA
authors: Estrada
authors: Michael B
authors: MB
authors: Faircloth
authors: Lisa
authors: L
authors: Oestreich
authors: Jeremy
authors: J
authors: Hatchett
authors: Walid
authors: W
authors: Khalife
authors: Ken B
authors: KB
authors: Waites
mesh_terms: D000293:Adolescent; D000328:Adult; D058070:Asymptomatic Diseases / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005674:Fusobacterium Infections / Q000453:epidemiology*; D005675:Fusobacterium necrophorum / Q000302:isolation & purification; D006801:Humans; D008297:Male; D009177:Mycoplasma pneumoniae / Q000302:isolation & purification; D010612:Pharyngitis / Q000453:epidemiology* / Q000382:microbiology*; D011019:Pneumonia, Mycoplasma / Q000453:epidemiology*; D015995:Prevalence; D060888:Real-Time Polymerase Chain Reaction; D013290:Streptococcal Infections / Q000453:epidemiology*; D013291:Streptococcus / Q000302:isolation & purification; D013297:Streptococcus pyogenes / Q000302:isolation & purification; D013333:Student Health Services; D014481:United States / Q000453:epidemiology; D055815:Young Adult