Prevalence of Fusobacterium necrophorum in Children Presenting with Pharyngitis

Fusobacterium necrophorum, an obligate anaerobic bacterium, was recently reported to be an important cause of bacterial pharyngitis with a prevalence as high as that of group A Streptococcus (GAS) in adolescents and young adults. Importantly, F. necrophorum is the primary causative agent of the life-threatening Lemierre’s syndrome and screening of pharyngeal samples may be warranted for its early detection and prevention.

The aim of this study was to determine the prevalence of F. necrophorum and groups A and C/G streptococci as agents of bacterial pharyngitis in children. Pharyngeal samples (n=300) were collected from pediatric patients presenting to the emergency department with signs and symptoms of pharyngitis. Overall, 10 (3.3%), 79 (26.3%), and 4 (1.3%) patients were PCR positive for F. necrophorum was significantly higher in patients between the ages of 14 and 20 years at 13.5% than in patients aged 14 years and younger (1.9%).

All positive patients presented with signs and symptoms similar to GAS pharyngitis. Our data demonstrated a potential role for F. necrophorum as a pathogen of pharyngitis among young adults, but suggests that the prevalence of F. necrophorum is low in preadolescent patients. All patients with pharyngeal samples collected using ESwab (Copan Diagnostics, Murrieta, CA) as part of standard-of-care testing for GAS pharyngitis were enrolled in the study once samples were received in the clinical microbiology laboratory.