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http://dx.doi.org/10.14776/piv.2016.23.1.40

Etiology of Acute Pharyngotonsillitis in Children: The Presence of Viruses and Bacteria  

Pyeon, Jong Seok (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
Moon, Kyung Pil (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
Kang, Jin Han (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
Ma, Sang Hyuk (Department of Pediatrics, Fatima Hospital)
Bae, Song Mi (Division of Bacterial Respiratory Infections, Center for Infectious Diseases, Korea National Institute of Health)
Publication Information
Pediatric Infection and Vaccine / v.23, no.1, 2016 , pp. 40-45 More about this Journal
Abstract
Purpose: The purpose of this study was to investigate the etiology of acute pharygotonsillitis in pediatric patients. Methods: Pharyngeal swabs from patients with acute pharyngotonsillitis were evaluated for viruses and bacterial organisms from March 2010 through March 2011. Results: Of 615 patients, potentially pathogenic bacteria were isolated in 40 (6.5%), viruses were isolated in 310 (50.4%), and no pathogens were isolated in 267 patients (43.4%). Both viral and bacterial pathogens were found in 2 (0.3%). Of 40 patients with bacterial pathogens, group A streptococci were found in 31 (77.5%). Among 310 patients with virus infection, adenovirus was the most frequently recovered (203 patients; 65.5%), followed by rhinovirus (65 patients; 21.0%), enterovirus (43 patients; 13.9%) and coronavirus (18 patients; 5.8%). There were 25 patients who had been coinfected with 2 viruses. In viral pharyngotonsillitis, cough, rhinorrhea, conjunctivitis and diarrhea were prominent. On the other hand, pharyngeal injection and pharyngeal petechiae were prominent in bacterial pharyngotonsillitis. Conclusions: Virus infection was a big part of acute pharyngotonsillitis and there were differences in clinical manifestations among viral and bacterial infections. Therefore, we need to distinguish between virus infection and bacterial infection using clinical signs for preventing the abuse of antibiotics.
Keywords
Acute pharyngotonsillitis; Children; Etiology;
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  • Reference
1 Bisno AL. Acute pharyngitis. N Engl J Med 2001;344:205-11.   DOI
2 Woodwell, D. Office visits to pediatric specialists, 1989, Advance data from vital and health statistics; no 208. Hyattsville, Maryland: National Center for Health Statistics, 1992.
3 National Health Insurance Service. Acute pharyngotonsillitis. Seoul: National Health Insurance Service, February 22, 2015.
4 Bae SM. Respiratory bacteria and viruses in the etiology of acute pharyngitis in Korea. PHWR 2012;5:58-62.
5 Gwaltney JM Jr, Bisno AL. Pharyngitis. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas and Bennett's principles and practice of infectious diseases. 5th ed. Philadelphia: Churchill Livingstone, 2000:656-62.
6 Tsou TP, Tan BF, Chang HY, Chen WC, Huang YP, Lai CY, et al. Community outbreak of adenovirus, Taiwan, 2011. Emerg Infect Dis 2012;18:1825-32.   DOI
7 Hsieh TH, Chen PY, Huang FL, Wang JD, Wang LC, Lin HK, et al. Are empiric antibiotics for acute exudative tonsillitis needed in children? J Microbiol Immunol Infect 2011;44:328-32.   DOI
8 Putto A. Febrile exudative tonsillitis: viral or streptococcal? Pediatrics 1987;80:6-12.
9 Appenzeller C, Ammann RA, Duppenthaler A, Gorgievski-Hrisoho M, Aebi C. Serum C-reactive protein in children with adenovirus infection. Swiss Med Wkly 2002;132:345-50.
10 Gerber MA. Diagnosis and treatment of pharyngitis in children. Pediatr Clin North Am 2005;52:729-47.   DOI
11 Dajani A, Taubert K, Ferrieri P, Peter G, Shulman S. Treatment of acute streptococcal pharyngitis and prevention of rheumatic fever: a statement for health professionals. Pediatrics 1995;96:758-64.
12 Tanz RR. Acute pharyngitis. In: Kliegman RM, Stanton BMD, St. Geme J, Schor NF, editors. Nelson textbook of pediatrics. 20th ed. Philadelphia: Elsevier, Inc. 2016:2017-21.
13 Brien JH, Base JW. Streptococcal pharyngitis: optimal site for throat culture. J Pediatr 1985;106:781-3.   DOI
14 Gerber MA, Shulman ST. Rapid diagnosis of pharyngitis caused by group A streptococci. Clin Microbiol Rev 2004;17:571-80.   DOI
15 Tanz RR, Gerber MA, Kabat W, Rippe J, Seshadri R, Shulman ST. Performance of a rapid antigen-detection test and throat culture in community pediatric offices: implications for management of pharyngitis. Pediatrics 2009;123:437-44.   DOI
16 Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis 2012;55:1279-82.   DOI
17 McIsaac WJ, White D, Tannenbaum D, Low DE. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ 1998;158:75-83.