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Viral and bacterial organisms associated with acute pharyngitis in a school-aged population
Insights
Group A Streptococcus and influenza A were common causes of acute pharyngitis in children. Mycoplasma pneumoniae was frequently detected in both patients and healthy children, suggesting it may not be a primary cause of illness.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Acute pharyngitis is a common illness in school-aged children.
- Identifying causative agents is crucial for appropriate treatment and management.
- Previous studies have indicated various pathogens, including bacteria and viruses.
Purpose of the Study:
- To determine the etiological agents of acute pharyngitis in children aged 4-18 years.
- To compare the prevalence of specific pathogens in symptomatic children versus asymptomatic controls.
- To describe the clinical characteristics associated with different causative agents.
Main Methods:
- Throat cultures were performed on 320 children with acute pharyngitis and 308 healthy controls.
- Cultures tested for respiratory viruses, Mycoplasma pneumoniae, group A Streptococcus, and Chlamydia trachomatis.
- Clinical symptoms were recorded for all participants.
Main Results:
- 60% of patients and 26% of controls had positive cultures for at least one organism.
- Group A Streptococcus was found in 40% of patients vs. 11.9% of controls.
- Influenza A was the predominant viral isolate (16% of patients vs. 2.6% of controls), associated with cough and hoarseness, and less with exudate or adenopathy.
- Mycoplasma pneumoniae was detected in 15.8% of patients and 17.6% of controls.
- Chlamydia trachomatis was not isolated from any participant.
Conclusions:
- Group A Streptococcus and influenza A are significant causes of acute pharyngitis in this pediatric population.
- The high prevalence of Mycoplasma pneumoniae in asymptomatic children suggests its detection alone is insufficient for diagnosing pharyngitis.
- Clinical presentation can help differentiate between Streptococcus and influenza A infections.
Abstract:
To investigate the causes and clinical characteristics of acute pharyngitis among school-aged children (4 to 18 years), we obtained throat cultures for respiratory viruses, Mycoplasma pneumoniae, group A streptococcus, and Chlamydia trachomatis from 320 patients with sore throat and 308 controls without respiratory complaints. The study was conducted from January to April 1985 in a private pediatric practice in central New York State. Sixty percent of the patients and 26% of the control subjects had positive cultures for at least one organism. Forty percent of patients had positive cultures for group A streptococcus, compared with 11.9% of the controls. Fifty (16%) patients had positive viral cultures, compared with eight (2.6%) controls; the predominant viral isolate was influenza A Philippines. Patients infected with influenza A were significantly more likely to complain of cough and hoarseness, and were less likely to have pharyngeal exudate or tender cervical adenopathy, than were patients who had positive cultures for group A streptococcus. Although 49 (15.8%) patients with acute pharyngitis had cultures positive for M. pneumoniae, 53 (17.6%) asymptomatic controls were also had M. pneumoniae-positive cultures. Thus detection of M. pneumoniae in the throat of school-aged children with pharyngitis may not be sufficient to establish a diagnosis of disease caused by this organism. C. trachomatis was not isolated from any patient or control.