New findings from the University of Alabama at Birmingham proposes that physicians ought to alter their diagnosis and treatment of sore throat, or pharyngitis, in adolescents and young adults. Apparently, they need to mull over a more recently recognized and potentially hazardous offender as the root of that infection.
Presently, physicians are supposedly trained to suppose group A streptococcal bacteria as the chief cause of pharyngitis. But as per recent discoveries, physicians also ought to search for the attendance of bacteria known as Fusobacterium necrophorum when treating sore throat in young adults and adolescents that deteriorates or is strep-negative.
Robert Centor, M.D., professor of internal medicine, associate dean of medicine at UAB and the paper’s lead author, commented, “F. necrophorum, which only has been recognized as a potential cause of pharyngitis in adolescents and young adults in the past five years, may cause up to 10 percent of sore throat in those 15-24 years of age. More important, F. necrophorum is associated with a rare but life-threatening complication called Lemierre syndrome.”
Adolescents and young adults could be frequently affected by Lemierre syndrome and is hardly ever seen in pre-adolescents. It starts with a sore throat, apparently pursued by an infected jugular vein after four to five days. Abscesses in different parts of the body may arise. About 5 percent of people who suffer from Lemierre syndrome expire.
Group A strep is also said to be associated with a grave impediment i.e. rheumatic fever but the occurrence rate of Lemierre syndrome following exposure to F. necrophorum is claimed to be much elevated and linked to bigger morbidity and death.
Centor mentioned, “The risk of Lemierre syndrome exceeds the risk of acute rheumatic fever, which is the classic reason that physicians worry about sore throats.”
Centor is of the opinion that clinicians must extend their diagnostic process for adolescents and young adults suffering from sore throat to consider F. necrophorum, particularly if one does not recover in three to five days. Centor mentioned that doctors ought to be alert of the red flags that might point out towards Lemierre syndrome, counting unilateral neck swelling, rigors, night sweats or high fevers. Apparently, no routine test is available for F. necrophorum pharyngitis and a CT scan is claimed to be necessary to diagnose Lemierre syndrome.
Powerful treatment with antibiotics like a grouping of penicillin and metronidazole or with clindamycin alone is thought to be apt. Centor anticipates that his investigations could result in enhanced diagnostic tests for the attendance of F. necrophorum.
The analysis was published in the Annals of Internal Medicine.