Symptoms predictive of Fusobacterium necrophorum pharyngotonsillitis - an observational study of cases presenting to hospitals in Southern Sweden.

Autor: Pagels J; Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden. josefina.pagels@gmail.com.; Department of Infectious Diseases, Skåne University Hospital, Lund/Malmö, Sweden. josefina.pagels@gmail.com., Torisson G; Department of Infectious Diseases, Skåne University Hospital, Lund/Malmö, Sweden.; Clinical Infection Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden., Wasserstrom L; Department of Clinical Microbiology, Infection Control and Prevention, Skåne University Hospital, Lund, Sweden.; Clinical Microbiology, Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden., Hedin K; Futurum, Jönköping, Region Jönköping County, Sweden.; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.; Department of Clinical Sciences in Malmö, Family Medicine, Lund University, Malmö, Sweden., Holm K; Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden.; Department of Infectious Diseases, Skåne University Hospital, Lund/Malmö, Sweden., Nygren D; Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden.; Department of Infectious Diseases, Skåne University Hospital, Lund/Malmö, Sweden.
Jazyk: angličtina
Zdroj: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology [Eur J Clin Microbiol Infect Dis] 2024 Jun; Vol. 43 (6), pp. 1099-1107. Date of Electronic Publication: 2024 Apr 12.
DOI: 10.1007/s10096-024-04827-6
Abstrakt: Objectives: Fusobacterium necrophorum is a common cause of pharyngotonsillitis. However, no guidelines exist on when to diagnose or treat it. We aimed to investigate associations between clinical criteria and F. necrophorum-positivity in pharyngotonsillitis and assess the predictive potential of a simple scoring system.
Methods: Pharyngotonsillitis patients who were tested for F. necrophorum (PCR) and presented to hospitals in the Skåne Region, Sweden, between 2013-2020 were eligible. Data were retrieved from electronic chart reviews and registries. By logistic regression we investigated associations between F. necrophorum-positivity and pre-specified criteria: age 13-30 years, symptom duration ≤ 3 days, absence of viral symptoms (e.g. cough, coryza), fever, tonsillar swelling/exudate, lymphadenopathy and CRP ≥ 50 mg/L. In secondary analyses, associated variables were weighted by strength of association into a score and its predictive accuracy of F. necrophorum was assessed.
Results: Among 561 cases included, 184 (33%) had F. necrophorum, which was associated with the following criteria: age 13-30, symptom duration ≤ 3 days, absence of viral symptoms, tonsillar swelling/exudate and CRP ≥ 50 mg/L. Age 13-30 had the strongest association (OR5.7 95%CI 3.7-8.8). After weighting, these five variables had a sensitivity and specificity of 68% and 71% respectively to predict F. necrophorum-positivity at the proposed cut-off.
Conclusion: Our results suggest that F. necrophorum cases presenting to hospitals might be better distinguished from other pharyngotonsillitis cases by a simple scoring system presented, with age 13-30 being the strongest predictor for F. necrophorum. Prospective studies, involving primary care settings, are needed to evaluate generalisability of findings beyond cases presenting to hospitals.
(© 2024. The Author(s).)
Databáze: MEDLINE
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