How Frequent Is Bacterial Superinfection of the Pharynx in Infectious Mononucleosis?

Abstract

Throat cultures from 133 patients with infectious mononucleosis were compared with cultures from 2,881 patients who were seen during the same period because of pharyngitis. Less than 3 per cent of the cultures from each group contained Group A beta hemolytic streptococci. The inflamed pharynx and necrotic tonsils of infectious mononucleosis are seldom subject to bacterial superinfection, either initially or during the course of the illness. There is no indication for routine use of antibiotics when infectious mononucleosis is diagnosed. Should, however, a throat culture indicate presence of a bacterial pathogen, any appropriate antibiotic except ampicillin may be used without increasing the incidence of skin rash.

Pharyngitis of infectious mononucleosis: computed tomography findings

“…5 Palatine petechiae are sometimes observed. 3,9,10 Although we have found no past reports that correlate the pathological and radiological fi ndings of infl amed tonsils, we speculate that CT enabled us to fi nd edema, a pseudomembrane, and exudates.…”

“…11 In our two cases, α-streptococci were detected in their pharyngeal cultures, but this bacterium is part of the normal fl ora in tonsils. 9 We think that our two cases of pharyngitis were caused by not bacterial super-infection but by the EBV infection. Because our cervical CT fi nding that streaky heterogeneous tonsils with interspersed low attenuation was compatible to a fi nding reported in the literature, it is thought that this radiological fi nding could be a useful hint that IM is a possible diagnosis.…”

“…Because IM is an illness due to a virus infection, antibiotics are no value unless there is a bacterial superinfection. 8,9 Uncomplicated IM generally heals within 3-4 weeks. 1 It is diffi cult to determine clinically that pharyngitis is caused by IM and certainly not by the physical examination.…”

Co-infection with Group A <i>Streptococci</i> and <i>Epstein-Barr</i> Virus Presenting with Acute Glomerulonephritis and Acute Left Ventricular Dysfunction

“…Henke et al similarly commented that 29% of more than 700 patients up to 25 years old with EBV illness had co-infection with GAS pharyngitis (4). In contrast, Chretien et al reported, from a prospective study of 150 college students with infectious mononucleosis, that only 2.4% showed positive throat cultures for GAS (5). To the best of our knowledge, the rate of co-infection in adolescents remains unclear.…”

Concurrent diphtheria and infectious mononucleosis: difficulties for management, investigation and control of diphtheria in developing countries

“…The difficulty of differentiating certain clinical forms of IM from diphtheria has been well recognized for decades (Chretien & Esswein, 1976). Making an accurate diagnosis is especially difficult in cases of concurrent diphtheria and IM.…”