title: The aetiology of pharyngotonsillitis in adolescents and adults - Fusobacterium necrophorum is commonly found.
abstract: Sore throat is common in primary healthcare. Aetiological studies have focused on the presence of a limited number of pathogens. The aim of the present study was to investigate the presence of a wide range of bacteria and viruses, including Fusobacterium necrophorum, in patients with pharyngotonsillitis and in asymptomatic controls. A prospective case control study was performed in primary healthcare in Kronoberg County, Sweden. Patients (n=220) aged 15 to 45 years with a suspected acute pharyngotonsillitis, and controls (n=128), were included. Nasopharyngeal and throat swabs were analysed for β-hemolytic streptococci, F. necrophorum, Mycoplasma pneumoniae, and Chlamydophila pneumoniae, and 13 respiratory viruses. Serum samples were analysed for antibodies to Epstein-Barr virus. The patient history and symptoms, including Centor score, were analysed in relation to pathogens. In 155/220 (70.5%) of the patients, as compared to 26/128 (20.3%) of the controls (p <0.001), at least one microorganism was found. Group A streptococci, F. necrophorum, and influenza B virus were the three most common findings, and all significantly more common in patients than in controls (p <0.001, p 0.001, and p 0.002, respectively). Patients with F. necrophorum only (n=14) displayed a lower Centor score than patients with Group A streptococcus only (n=46), but a higher score than patients with influenza B, other viruses, or no potential pathogen (Kruskal-Wallis p <0.001). A pathogen was detected in 70% of the patients, displaying a wide range of pathogens contributing to the aetiology of pharyngotonsillitis. This study supports F. necrophorum as one of the pathogens to be considered in the aetiology of pharyngotonsillitis.
authors: Department of Clinical Sciences, Family Medicine, Lund University, Malmö, Sweden; Unit for Research and Development, Kronoberg County Council, Växjö, Sweden. Electronic address: katarina.hedin@ltkronoberg.se.
authors: K
authors: K
authors: Hedin
authors: Department of Clinical Microbiology, Central Hospital, Växjö, Sweden.
authors: L
authors: L
authors: Bieber
authors: Department of Clinical Virology, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors: M
authors: M
authors: Lindh
authors: Department of Laboratory Medicine, Clinical Microbiology, University Hospital, Örebro, Sweden.
authors: M
authors: M
authors: Sundqvist
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005674:Fusobacterium Infections / Q000453:epidemiology / Q000382:microbiology; D005675:Fusobacterium necrophorum; D006801:Humans; D008297:Male; D008875:Middle Aged; D010612:Pharyngitis / Q000453:epidemiology* / Q000209:etiology* / Q000382:microbiology / Q000821:virology; D011446:Prospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D014069:Tonsillitis / Q000453:epidemiology* / Q000209:etiology* / Q000382:microbiology / Q000821:virology; D055815:Young Adult
keywords: Aetiology; centor score; pharyngotonsillitis; primary healthcare