Nonstreptococcal pharyngitis

Abstract

Pharyngitis is the third most common illness diagnosed by pediatricians in the United States. Group A I~-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 I~-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. Copyright 9 1998 by W.B. Saunders Company

The role of group C and group G streptococci in acute pharyngitis in children

“…Non-group A b-haemolytic streptococci, particularly Lancefield groups C (GCS) and G (GGS), have been implicated as causes of acute pharyngitis in children [1][2][3][4][5][6][7] and adults [8][9][10][11]. These organisms have caused well-documented epidemic, often food-borne, outbreaks of pharyngitis [2][3][4][5][6][7]. The importance of these organisms in causing acute, sporadic pharyngitis is uncertain.…”

“…equisimilis ) and GGS are closely related and are often termed ‘ pyogenes ‐like’, because they share virulence factors, including haemolysins, extracellular enzymes, and M‐proteins, with group A streptococci ( S. pyogenes ) [12,14–16]. Small‐colony‐forming phenotypes, regardless of Lancefield group carbohydrate, are placed in the Streptococcus anginosus group (formerly known as Streptococcus milleri ), and are not believed to be significant causes of pharyngitis, but are infrequent causes of abscess formation and bacteraemia [6,8,17,18].…”