The clinical presentation of Fusobacterium-positive and streptococcal-positive pharyngitis in a university health clinic: a cross-sectional study.

Academic Article


  • BACKGROUND: Pharyngitis guidelines focus solely on group A β-hemolytic streptococcal infection. European data suggest that in patients aged 15 to 30 years, Fusobacterium necrophorum causes at least 10% of cases of pharyngitis; however, few U.S. data exist. OBJECTIVE: To estimate the prevalence of F. necrophorum; Mycoplasma pneumoniae; and group A and C/G β-hemolytic streptococcal pharyngitis and to determine whether F. necrophorum pharyngitis clinically resembles group A β-hemolytic streptococcal pharyngitis. DESIGN: Cross-sectional. SETTING: University student health clinic. PATIENTS: 312 students aged 15 to 30 years presenting to a student health clinic with an acute sore throat and 180 asymptomatic students. MEASUREMENTS: Polymerase chain reaction testing from throat swabs to detect 4 species of bacteria and signs and symptoms used to calculate the Centor score. RESULTS: Fusobacterium necrophorum was detected in 20.5% of patients and 9.4% of asymptomatic students. Group A β-hemolytic streptococcus was detected in 10.3% of patients and 1.1% of asymptomatic students. Group C/G β-hemolytic streptococcus was detected in 9.0% of patients and 3.9% of asymptomatic students. Mycoplasma pneumoniae was detected in 1.9% of patients and 0 asymptomatic students. Infection rates with F. necrophorum, group A streptococcus, and group C/G streptococcus increased with higher Centor scores (P < 0.001). LIMITATIONS: The study focused on a limited age group and took place at a single institution. Asymptomatic students-rather than seasonal control participants-and a convenience sample were used. CONCLUSION: Fusobacterium necrophorum-positive pharyngitis occurs more frequently than group A β-hemolytic streptococcal-positive pharyngitis in a student population, and F. necrophorum-positive pharyngitis clinically resembles streptococcal pharyngitis. PRIMARY FUNDING SOURCE: University of Alabama at Birmingham and the Justin E. Rodgers Foundation.
  • Published In


  • Adolescent, Adult, Asymptomatic Diseases, Cross-Sectional Studies, Female, Fusobacterium Infections, Fusobacterium necrophorum, Humans, Male, Mycoplasma pneumoniae, Pharyngitis, Pneumonia, Mycoplasma, Prevalence, Real-Time Polymerase Chain Reaction, Streptococcal Infections, Streptococcus, Streptococcus pyogenes, Student Health Services, United States, Young Adult
  • Digital Object Identifier (doi)

    Author List

  • Centor RM; Atkinson TP; Ratliff AE; Xiao L; Crabb DM; Estrada CA; Faircloth MB; Oestreich L; Hatchett J; Khalife W
  • Start Page

  • 241
  • End Page

  • 247
  • Volume

  • 162
  • Issue

  • 4