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Incidence of beta hemolytic streptococcal pharyngitis in adolescent with infectious mononucleosis
Abstract:
Reports on the incidence of beta-hemolytic group A streptococci (BHGAS) in the pharynx of patients with infectious mononucleosis (IM) have varied from 3% to 33%. To ascertain the rate of infection, we prospectively performed serial throat cultures and determined anti-streptococcal antibody titers on 45 students with confirmed IM by Epstein-Barr virus-specific serology. One hundred healthy control students had throat cultures for comparison. The rate of recovery of BHGAS was similar in patients with IM (4%) and controls (3%). No students with IM had a fourfold rise of anti-streptococcal antibodies. We conclude that routine culture for BHGAS and/or treatment with antibiotic agents is not indicated in all patients with IM.
Insights
Infectious mononucleosis (IM) patients show a low incidence of beta-hemolytic group A streptococci (BHGAS) infection, similar to healthy individuals. Routine BHGAS testing and antibiotic treatment are not typically necessary for IM cases.
Area of Science:
- Infectious Diseases
- Microbiology
- Immunology
Background:
- Infectious mononucleosis (IM) is a common viral illness.
- Previous studies reported varied rates of co-infection with beta-hemolytic group A streptococci (BHGAS) in IM patients, ranging from 3% to 33%.
Purpose of the Study:
- To prospectively determine the actual incidence of BHGAS pharyngeal colonization in patients with confirmed IM.
- To compare BHGAS rates in IM patients versus a healthy control group.
- To assess the need for routine BHGAS screening and antibiotic treatment in IM.
Main Methods:
- Serial throat cultures were performed on 45 students diagnosed with IM via Epstein-Barr virus serology.
- Anti-streptococcal antibody titers were measured in IM patients.
- Throat cultures were also conducted on 100 healthy control students for comparison.
Main Results:
- The recovery rate of BHGAS was low and similar between IM patients (4%) and healthy controls (3%).
- No significant rise in anti-streptococcal antibody titers was observed in the IM group.
- These findings indicate no increased susceptibility to BHGAS in IM patients.
Conclusions:
- Routine throat cultures for BHGAS are not indicated for all patients diagnosed with infectious mononucleosis.
- Antibiotic treatment for BHGAS is generally not warranted in IM patients unless clinically indicated.
- The study clarifies the low co-infection rate of BHGAS in IM, guiding clinical practice.