Chronic pharyngitis: role of atypical organisms: a case control study from South India
P Naina1, Shalini Anandan, Suma Susan Mathews
1Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India. naina.emmanuel@yahoo.com
Background:
Bacteria including Chlamydophila pneumoniae, Mycoplasma pneumoniae, and anaerobic bacteria such as Fusobacterium necrophorum have been implicated as etiological agents of chronic pharyngitis in Western literature. Because there are no data regarding this from India, the authors undertook this study.
Study Design:
Prospective case-control study.
Setting:
Tertiary-level medical college and hospital.
Method:
In total, 343 consecutive adults with persistent throat pain and/or irritation (duration ≥3 months) were screened for known causes of pharyngitis by a thorough clinical and endoscopic examination. In 71 patients, the evaluation performed was unable to determine any cause, and these were considered cases. An enzyme-linked immunosorbent assay test to detect IgA and IgG antibodies to C pneumoniae and M pneumoniae was performed on 66 of these cases and 62 controls. The posterior pharyngeal swabs taken from both the cases and controls were subjected to aerobic and anaerobic culture.
Results:
Individuals with chronic pharyngitis had a 3.43 times odds of being seropositive for C pneumoniae as compared with controls (P = .001; odds ratio = 3.43). Aerobic organisms and M pneumoniae did not seem to be significant etiological agents for chronic pharyngitis. On the contrary, isolation of Fusobacterium spp was found to be significantly more in controls as compared with cases.
Conclusion:
This study suggests an association between IgA antibodies to C pneumoniae and chronic pharyngitis. Further studies using more specific tests combined with long-term follow-up are needed to confirm these findings.
Insights
Chlamydophila pneumoniae infection is linked to chronic pharyngitis in India. This study found higher C. pneumoniae antibody levels in patients with persistent throat pain, suggesting it as a potential cause.
Area of Science:
- Infectious Diseases
- Otolaryngology
- Microbiology
Background:
- Western studies implicate bacteria like Chlamydophila pneumoniae in chronic pharyngitis.
- Limited data exists on chronic pharyngitis causes in India.
Purpose of the Study:
- To investigate potential etiological agents of chronic pharyngitis in India.
- To explore the role of C. pneumoniae and Mycoplasma pneumoniae.
Main Methods:
- Prospective case-control study involving 343 adults with persistent throat symptoms.
- Serological testing (IgA, IgG) for C. pneumoniae and M. pneumoniae.
- Aerobic and anaerobic cultures of posterior pharyngeal swabs.
Main Results:
- Chronic pharyngitis cases showed a 3.43-fold increased odds of being seropositive for C. pneumoniae (P = .001).
- M. pneumoniae and aerobic bacteria were not significant etiological agents.
- Fusobacterium spp. were isolated more frequently in controls than in cases.
Conclusions:
- An association exists between IgA antibodies to C. pneumoniae and chronic pharyngitis.
- Further research with specific tests and long-term follow-up is recommended.
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