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Clinical features of acute pharyngitis by pathogen

Clinical features of acute pharyngitis by pathogen
  Pathogen Relative frequency* Associated clinical syndrome and/or symptoms
Bacteria Group A Streptococcus Common Fever, tonsillar exudates, tender cervical lymphadenopathy, scarlatiniform rash, particularly in an adolescent or young adult
Group C or G Streptococcus Less common Similar to GAS pharyngitis but more frequently acquired in a waterborne or foodborne outbreak
Arcanobacterium haemolyticum Less common Similar to GAS pharyngitis, scarlatiniform rash common, particularly in adolescents and young adults
Fusobacterium necrophorum Uncertain Lemierre syndrome (septic jugular vein thrombophlebitis), possible association with recurrent or persistent pharyngitis
Neisseria gonorrhoeae Likely rare Nonspecific symptoms such as acute sore throat, pharyngeal exudates, and cervical lymphadenopathy in a patient with risk factors for sexually transmitted infections, particularly receptive oral intercourse
Corynebacterium diptheriae Rare Diphtheria: Low-grade fever, anorexia, malaise, sore throat with gray-white membrane on palate, tonsil or posterior oropharynx, cervical lymphadenopathy, particularly in a patient who has not been vaccinated
Mycoplasma pneumoniae Rare Cough, pneumonia
Chlamydia pneumoniae Rare Fever, cough, laryngitis, pneumonia
Treponema pallidum Rare Secondary syphilis: Sore throat may precede development of mucosal ulcers, generalized lymphadenopathy and palmar-plantar rash
Francisella tularemia Rare Ulceroglandular fever: Severe sore throat, pharyngeal exudes, cervical lymphadenopathy (often posterior and bilateral), oral ulcers; usually acquired by ingestion of contaminated water
Viruses Respiratory viruses Very common Common cold: Fever, rhinorrhea, cough, hoarseness, coryza, conjunctivitis, oral ulcers
Epstein-Barr virus Common Infectious mononucleosis: Fever, fatigue, tender cervical lymphadenopathy, splenomegaly, lymphocytosis, particularly in an adolescent or young adult
Herpes simplex virus Less common Severe sore throat, with or without oral ulcers
Cytomegalovirus Rare Mononucleosis-like syndrome, similar to EBV but typically milder
HIV Rare Acute retroviral syndrome: Fever, fatigue, lymphadenopathy, rash, myalgias, arthralgias, diarrhea, weight loss, painful mucocutaneous ulcers

EBV: Epstein-Barr virus; GAS: group A Streptococcus; HIV: human immunodeficiency virus.

* The precise frequency of the etiologies of pharyngitis are not known and likely varies among different populations. In resource-rich regions, the designation of very common is used to indicate causes that are generally considered to exceed 25%, common to exceed 5%, less common to account for 1 to 5%, and rare <1%.
Graphic 116702 Version 5.0

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