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Updated: Dec 24, 2025
Capsular Serotyping of Streptococcus pneumoniae Using the Quellung Reaction
Published on: February 24, 2014
Nonstreptococcal pharyngitis
1University of Pittsburgh School of Medicine, Division of Allergy, Immunology, and Infectious Diseases, Children's Hospital of Pittsburgh, Pittsburgh, PA. USA.
Insights
Pharyngitis is common in children. While Group A Streptococcus causes about 30% of cases, this review examines other bacteria and viruses responsible for the remaining 70% of pharyngitis infections.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Clinical diagnostics
Background:
- Pharyngitis is a frequent pediatric diagnosis in the U.S.
- Group A ß-hemolytic streptococci (GAS) cause only about 30% of symptomatic pharyngitis cases.
- The remaining 70% are attributed to diverse pathogens, including other bacteria and viruses.
Purpose of the Study:
- To review evidence implicating non-GAS ß-hemolytic streptococci, other bacteria, and viruses in pharyngitis.
- To provide diagnostic and management recommendations for pharyngitis caused by these alternative pathogens.
Main Methods:
- Literature review of studies on bacterial and viral pharyngitis.
- Analysis of evidence for causative roles in sporadic and outbreak cases.
- Synthesis of current diagnostic and treatment guidelines.
Main Results:
- Evidence supports the role of various pathogens beyond *Streptococcus pyogenes* in pharyngitis.
- Specific bacterial and viral agents are frequently implicated in the remaining 70% of cases.
- Outbreaks and sporadic infections involve a spectrum of microorganisms.
Conclusions:
- Diagnosis and management of pharyngitis should consider pathogens beyond *S. pyogenes*.
- Updated recommendations are needed for comprehensive pharyngitis care.
- Further research may clarify the etiology of undiagnosed pharyngitis cases.
Abstract:
Pharyngitis is the third most common illness diagnosed by pediatricians in the United States. Group A ß-hemolytic streptococci account for only approximately 30% of episodes of symptomatic pharyngitis. A broad list of other pathogens, including both bacteria and viruses, as well as Toxoplasma gondii and Candida species, are suggested frequently as the pathogens responsible for the remaining 70% of cases. This article reviews the evidence for a causative role of ß-hemolytic streptococci other than Streptococcus pyogenes and other bacteria and viruses in outbreaks and sporadic cases of pharyngitis. Recommendations for the diagnosis and management of pharyngitis caused by pathogens other than S pyogenes are offered.
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