F. necrophorum More Common Than Group A Strep in Young Adults with Pharyngitis

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

In young adults presenting with pharyngitis, Fusobacterium necrophorum is twice as common as group A streptococcus, according to a single-center study in the Annals of Internal Medicine.

Some 310 young adults (aged 15–30) presenting with pharyngitis at an Alabama university clinic underwent polymerase chain reaction testing for bacteria in throat swab specimens; 180 asymptomatic students were also tested.

F. necrophorum was identified in 21% of patients with pharyngitis (and 9% of asymptomatic students), while group A streptococcus was found in just 10% of patients (and 1% of asymptomatic students). Clinical presentations were similar for F. necrophorum and group A strep.

Paul Sax, a contributing editor with NEJM Journal Watch Infectious Diseases, commented: "The high rate of fusobacterium infection found in symptomatic young adults raises questions about the optimal treatment of non-group A pharyngitis in this population. At the very least, azithromycin (which lacks activity against this organism) should be avoided."