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Clin Microbiol Infect 2021 May 5. Epub 2021 May 5.

Université de Paris, Centre of Research in Epidemiology and Statistics (CRESS), INSERM, F-75004, Paris, France; Necker-Enfants malades Hospital, APHP, Université de Paris, Department of General Pediatrics and Pediatric Infectious Diseases, Paris, France. Electronic address:

Background: Acute pharyngitis is one of the most common conditions in outpatient settings and an important source of inappropriate antibiotic prescribing. Rapid antigen detection tests (RADTs) offer diagnosis of group A streptococcus (GAS) at the point of care but have limited sensitivity. Rapid nucleic acid tests (RNATs) are now available; a systematic review of their accuracy is lacking. Read More

BMC Fam Pract 2021 May 6;22(1):87. Epub 2021 May 6.

School, of Public Health, Anhui Medical University, Hefei, Anhui, China.

Background: This paper tries to describe prevalence and patterns of antibiotics prescription and bacteria detection and sensitivity to antibiotics in rural China and implications for future antibiotic stewardship.

Methods: The study was implemented in one village clinic and one township health center in each of four rural residential areas in Anhui Province, China. It used mixed-methods comprising non-participative observations, exit-survey and microbiological study. Read More

mBio 2021 05 4;12(3). Epub 2021 May 4.

Department of Pharmaceutical Sciences, University of Illinois at Chicago, Chicago, Illinois, USA

Some bacterial pathogens utilize cell-cell communication systems, such as quorum sensing (QS), to coordinate genetic programs during host colonization and infection. The human-restricted pathosymbiont (group A streptococcus [GAS]) uses the Rgg2/Rgg3 QS system to modify the bacterial surface, enabling biofilm formation and lysozyme resistance. Here, we demonstrate that innate immune cell responses to GAS are substantially altered by the QS status of the bacteria. Read More

Vestn Otorinolaringol 2021 ;86(2):85-89

Ural Research Institute of Dermatovenerology and Immunopathology, Ekaterinburg, Russia.

A description of a clinical case of oligosymptomatic pharyngitis associated with Neisseria gonorrhoeae is presented. On the example of oligosymptomatic localized gonococcal pharyngitis in a sexually active young man, included in the risk group for extragenital forms of sexually transmitted infections, an advantage has been shown molecular biological diagnostic method. Study of the spectrum of microflora of the oropharynx and urethra with assessment sensitivity to antibacterial drugs of representatives of the genus Neisseria isolated during mixed infection oropharynx, demonstrated that non-pathogenic Neisseria species are resistant to cephalosporins III-IV generations. Read More

PLoS One 2021 29;16(4):e0248201. Epub 2021 Apr 29.

Division of Infectious Diseases, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, United States of America.

Streptococcus pyogenes or group A Streptococcus (GAS) is a leading cause of bacterial pharyngitis, skin and soft tissue infections, life-threatening invasive infections, and the post-infectious autoimmune syndromes of acute rheumatic fever and post-streptococcal glomerulonephritis. Genetic manipulation of this important pathogen is complicated by resistance of the organism to genetic transformation. Very low transformation efficiency is attributed to recognition and degradation of introduced foreign DNA by a type I restriction-modification system encoded by the hsdRSM locus. Read More

Neurohospitalist 2021 Jan 16;11(1):62-65. Epub 2020 Jul 16.

Department of Medicine and Pathology and Laboratory Medicine, University of Calgary, Alberta, Canada.

West Nile virus is an emerging infection in North America but has not traditionally been associated with acute vascular events. We report a 57-year-old healthy male who developed pharyngitis and a corporeal rash, followed 1 week later by an acute cryptogenic stroke. Following successful endovascular thrombectomy, cerebrospinal fluid analysis revealed acute West Nile virus infection. Read More

J Infect Dev Ctries 2021 Mar 31;15(3):415-421. Epub 2021 Mar 31.

MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom.

Introduction: Pharyngitis is one of the most common diagnoses for antibiotic prescriptions worldwide. Antibiotics should be prescribed for bacterial pharyngitis to reduce its complications. The aims of this study were to assess antibiotic prescriptions for pharyngitis cases, and their relationship with physicians' knowledge regarding its diagnosis and management. Read More

Drugs Context 2021 26;10. Epub 2021 Mar 26.

Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.

The goal of this narrative review of pharyngitis is to summarize the practical aspects of the management of sore throat in children in high- and middle-income countries. A traditional review of the literature was performed. Most cases of pharyngitis are viral and self-limited, although rarely viral pharyngitis due to Epstein-Barr leads to airway obstruction. Read More

Laryngorhinootologie 2021 04 30;100(4):291-293. Epub 2021 Mar 30.

Department of Radiology, University Hospital Gießen, Gießen, Germany.

Case Rep Infect Dis 2021 12;2021:6623834. Epub 2021 Mar 12.

Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Infectious mononucleosis (IM) due to Epstein-Barr virus (EBV) infection is usually self-limited. It presents with fever, pharyngitis, fatigue, and cervical lymph node enlargement. It is common among adolescents and young adults. Read More

J Ethnopharmacol 2021 Mar 22:114066. Epub 2021 Mar 22.

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China; Institute of Integration of Traditional and Western Medicine, Guangzhou Medical University, Guangzhou, China. Electronic address:

Ethnopharmacological Relevance: Liu Shen Wan (LSW) is a traditional Chinese medicine (TCM) with detoxification and antiphlogistic activity; it is composed of bezoar, toad venom, musk, pearl powder, borneol and realgar. In recent years, LSW has been widely used in traditional medicine for the treatment of influenza, tonsillitis, pharyngitis, mumps, cancer and leukaemia.

Aim Of Study: The anti-influenza virus properties of LSW and its inhibition of the inflammatory response was demonstrated in our previous research; however, the effect and potential mechanism of LSW against influenza induced secondary bacteria have remained obscure. Read More

J Am Coll Health 2021 Mar 24:1-5. Epub 2021 Mar 24.

Division of Ambulatory Care, Department of Emergency Medicine, West Virginia University, Morgantown, West Virginia, USA.

Familiarity breeds complacency. One case of sore throat can start to sound like another. However, even common viral and bacterial infections can lead to serious sequelae. Read More

Acute Med 2021 ;20(1):78-82

MB, BCh, BAO, FRCP, PhD, Acute Medicine Unit, Wards 7B and 7C, Royal Victoria Hospital, Belfast.

We present the case of a previously healthy, immunocompetent male with Lemierre's Syndrome. He presented with headache, sore throat and pyrexia. Initial blood tests revealed raised inflammatory markers and electrolyte abnormalities. Read More

J Prim Care Community Health 2021 Jan-Dec;12:21501327211003687

School of Medicine, Cardiff University, Cardiff, UK.

Background: The COVID-19 pandemic has changed the delivery of primary care in the NHS. Consultations have largely moved from face-to-face to remote, forcing practitioners to modify the ways in which they deliver care to patients.

Aim: In this study, we aim to investigate the appropriateness of antibiotic prescribing in tonsillitis during the COVID-19 pandemic. Read More

Cochrane Database Syst Rev 2021 03 17;3:CD004406. Epub 2021 Mar 17.

Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium.

Background: Antibiotics provide only modest benefit in treating sore throat, although their effectiveness increases in people with positive throat swabs for group A beta-haemolytic streptococci (GABHS). It is unclear which antibiotic is the best choice if antibiotics are indicated. This is an update of a review first published in 2010, and updated in 2013, 2016, and 2020. Read More

Br J Biomed Sci 2021 Apr 14:1-10. Epub 2021 Apr 14.

Department of Biological Sciences, Munster Technological University, Bishopstown, Cork, Ireland.

EBV is the sole causative agent of the acute illness in humans described either as infectious mononucleosis (IM), or glandular fever. IM, when not clinically silent, can present in patients with at least two of the classic triad of symptoms of fever, pharyngitis, and lymphadenopathy. Challenges for the clinician arise when atypical cases present. Read More

Dtsch Arztebl Int 2021 03 19;118(Forthcoming). Epub 2021 Mar 19.

Background: Sore throat is a common reason for consultation of primary care physicians, pediatricians, and ENT specialists. The updated German clinical practice guideline on sore throat provides evidence-based recommendations for treatment in the German healthcare system.

Methods: Guideline revision by means of a systematic search of the literature for international guidelines and systematic reviews. Read More

mBio 2021 02 9;12(1). Epub 2021 Feb 9.

Department of Microbiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

Group A (GAS; ) is a major human pathogen that causes streptococcal pharyngitis, skin and soft tissue infections, and life-threatening conditions such as streptococcal toxic-shock syndrome. During infection, GAS not only invades diverse host cells but also injects effector proteins such as NAD-glycohydrolase (Nga) into the host cells through a streptolysin O (SLO)-dependent mechanism without invading the cells; Nga and SLO are two major virulence factors that are associated with increased bacterial virulence. Here, we have shown that the invading GAS induces fragmentation of the Golgi complex and inhibits anterograde transport in the infected host cells through the secreted toxins SLO and Nga. Read More

J Laryngol Otol 2021 Jan 22;135(1):64-69. Epub 2021 Jan 22.

Department of Infectious Diseases, Södra Älvsborg Hospital, Borås, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sweden.

Objective: This study aimed to compare antibiotic treatment with clindamycin versus penicillin V or G in terms of time to recovery and recurrence in patients with peritonsillar infection, including both peritonsillar cellulitis and peritonsillar abscess.

Method: This retrospective cohort study examined the records of 296 patients diagnosed with peritonsillar infection. Based on the ENT doctor's choice of antibiotics, patients were divided into clindamycin and penicillin groups. Read More

Vestn Otorinolaringol 2020 ;85(6):90-99

Moscow Regional Research and Clinical Institute (MONIKI), Moskow, Russia.

Acute tonsillopharyngitis is one of the most frequent reasons for visiting a doctor and prescribing inappropriate antibiotic therapy (ABT). There are several reasons for this - from the difficulties of etiological diagnosis and the development of relapses and possible severe complications to the personal attitude of doctors and patients to the choice of treatment. At the same time, the issue of antibiotic resistance and other aspects associated with the prescription of ABT is one of the most important problems of modern healthcare worldwide. Read More

Vestn Otorinolaringol 2020 ;85(6):84-89

All-Russian public organization «Pediatric Respiratory Society», Kolomna, Russia.

Introduction: Acute tonsillopharyngitis (ATP) is a very common disease in children. In non-streptococcal ATP, systemic antibiotics are usually not indicated, but topical antimicrobial therapy is advisable.

Objective: To evaluate the effectiveness of the combination of cetylpyridinium chloride with gramicidin C in the form of a spray in children with ATP in a prospective multicenter non-interventional study. Read More

Medicine (Baltimore) 2021 Jan;100(2):e24316

Department of Pediatrics.

Introduction: Mycoplasma pneumoniae (MP) infection in infants is usually overlooked and it might result in important complications if left untreated. MP-induced arthritis is probably the least common extrapulmonary manifestation and frequently leads to delays in the diagnosis.

Patient Concerns: We report the case of a 2-year-old female child admitted in our clinic for prolonged fever (onset 2 weeks before the admission), for which the general practitioner established the diagnosis of acute pharyngitis and recommended antibiotics. Read More

BMJ Case Rep 2021 Jan 18;14(1). Epub 2021 Jan 18.

Paediatrics, Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan.

Group A streptococcus (GAS) causes a wide variety of infections in the paediatric population, ranging from pharyngitis to rare but severe invasive diseases, such as bacterial arthritis and osteomyelitis. Dental neglect is a type of child neglect in which caregivers fail to provide adequate care and treatment for dental diseases. This results in poor oral hygiene and can lead to complications including sepsis. Read More

J Biol Regul Homeost Agents 2020 Nov-Dec;34(6 Suppl. 1):11-18

The Italian Study Group on Upper Respiratory Infections.

Pharyngotonsillitis is a common disease, mainly characterized by a sore throat. It may be classified as acute or chronic, based on duration. The diagnosis is usually performed on the clinical ground, and antibiotic therapy is frequently used in clinical practice. Read More

Front Cell Infect Microbiol 2020 23;10:583137. Epub 2020 Dec 23.

Department of Microbiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Bacterial autophagy-a type of macroautophagy that is also termed xenophagy-selectively targets intracellular bacteria such as group A (GAS), a ubiquitous pathogen that causes numerous serious diseases, including pharyngitis, skin infections, and invasive life-threatening infections. Although bacterial autophagy is known to eliminate invading bacteria the action of autophagy receptors, the underlying mechanism remains unclear. Herein, we elucidated that Tollip functions as a bacterial-autophagy receptor in addition to participating involved in the intracellular immunity mechanism that defends against bacterial infection. Read More

Infect Drug Resist 2020 31;13:4739-4749. Epub 2020 Dec 31.

Institute of Clinical Microbiology, Faculty of Medicine, University of Szeged, Szeged, Hungary.

Introduction: Pyogenic β-hemolytic streptococci (including Group A, C and G ) are some of the most important Gram-positive bacterial pathogens in human medicine. Although effective therapy is available, invasive streptococcal infections are associated with a significant disease burden.

Methods: In this retrospective study, the epidemiological characteristics of invasive Group A (iGAS) and Group C and G (iGCGS) streptococci, along with tonsillo-pharyngitis-causing pGAS and pGCGS infections, were assessed in Southern Hungary. Read More

Head Neck Pathol 2020 Dec 28. Epub 2020 Dec 28.

Vanderbilt University Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, 1215 21st Ave. S. Suite 7209, Nashville, TN, 37232, USA.

Supraglottitis is a life-threatening, predominantly bacterial disease that is rarely caused by viral etiologies. Herpes Simplex Virus (HSV) supraglottitis has been infrequently reported, but its presentation can mimic that of bacterial supraglottitis or pharyngitis which may lead to delayed diagnosis and increased morbidity. We present a case of supraglottitis in an immunocompetent man initially thought to have bacterial epiglottitis. Read More

BMJ Case Rep 2020 Dec 18;13(12). Epub 2020 Dec 18.

Otorhinolaryngology, Pedro Hispano Hospital, Porto, Matosinhos, Portugal.

A 38-year-old woman with Crohn's disease, under immunosuppressive therapy, was referred to the emergency department for severe progressive neck pain and fever, with 1 week of evolution. She was unable to perform neck mobilisation due to the intense pain aroused. She referred dysphagia. Read More

Autoimmun Rev 2021 Feb 14;20(2):102740. Epub 2020 Dec 14.

School of Health and Wellbeing, University of Southern Queensland, Toowoomba, Queensland, Australia; Institute for Life Sciences and the Environment, University of Southern Queensland, Toowoomba, Queensland, Australia. Electronic address:

Rheumatic heart disease (RHD) is a serious and long-term consequence of acute rheumatic fever (ARF), an autoimmune sequela of a mucosal infection by Streptococcus pyogenes (Group A Streptococcus, Strep A). The pathogenesis of ARF and RHD is complex and not fully understood but involves host and bacterial factors, molecular mimicry, and aberrant host innate and adaptive immune responses that result in loss of self-tolerance and subsequent cross-reactivity with host tissues. RHD is entirely preventable yet claims an estimated 320 000 lives annually. Read More

Sex Transm Infect 2021 03 16;97(2):118. Epub 2020 Dec 16.

Department of Infection Prevention and Control, Tokyo Medical University Hospital, Shinjuku, Tokyo, Japan.

We report a five-time recurrent pharyngotonsillitis caused by group A streptococcus (GAS) after sexual contacts and had no recurrence after concurrent therapy to both partners. Although (GAS) is a Gram-positive streptococcus capable of causing a recurrent pharyngotonsillitis, the recurrent GAS pharyngotonsillitis as STI has not been published.A 30-year-old man had a high fever and sore throat. Read More