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Pharyngitis is usually caused by viruses. Guidelines in the U.S. focus on distinguishing such cases from those caused by group A streptococci, with the latter warranting antibiotic treatment to shorten illness, decrease suppurative complications and contagion, and lessen the probability of rheumatic fever. But what about Fusobacterium necrophorum, which is also usually sensitive to penicillin? Some studies done in Europe have shown that this organism underlies about 10% of pharyngitis cases in adolescents and young adults and may cause serious sequelae such as peritonsillar abscess and Lemierre syndrome.
Now, researchers have examined the prevalence of F. necrophorum in 312 15- to 20-year-olds presenting with pharyngitis at a student health …