Which organisms cause bacterial pharyngitis (sore throat)?

Updated: May 06, 2020
  • Author: John R Acerra, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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See the list below:

  • Bacterial pharyngitis

    • Group A beta-hemolytic streptococci (GABHS): The classic clinical picture includes a fever, temperature of greater than 101.5°F; tonsillopharyngeal erythema and exudate; swollen, tender anterior cervical adenopathy; headache; emesis in children; palatal petechiae; midwinter to early spring season; and absent cough or rhinorrhea. [17, 18]

    • Group C, G, and F streptococci may be indistinguishable clinically from GAS infection. Acute glomerulonephritis is an extremely unusual complication of group C streptococcal pharyngitis, but a relationship between group G streptococcal pharyngitis and acute glomerulonephritis has not be established. Acute rheumatic fever has not been described as a complication of either. They may be associated with food-borne outbreaks. The benefit of antibiotic therapy with these types of streptococci is unproven at this time. [7]

    • Arcanobacterium (Corynebacterium) haemolyticus is more common in young adults and is very similar to GAS infection, including a similar scarlatiniform rash. Patients often have a cough. Occasional outbreaks have been reported.

    • M pneumoniae in young adults presents with headache, pharyngitis, and lower respiratory symptoms. Approximately 75% of patients have a cough, which is distinctive from GAS infection.

    • C pneumoniae has a clinical picture similar to that of M pneumoniae. Pharyngitis usually precedes the pulmonary infection by about 1-3 weeks.

    • Neisseria gonorrhoeae is a rare cause of pharyngitis. A careful history is important since infection usually follows orogenital contact. It may be associated with severe systemic infection.

    • Corynebacterium diphtheriae is rare in the United States. A foul-smelling gray-white pharyngeal membrane may result in airway obstruction.

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