Please use this identifier to cite or link to this item: https://scholarhub.balamand.edu.lb/handle/uob/5266
Title: The burden of Arcanobacterium haemolyticum pharyngitis: A systematic review and management algorithm
Authors: Sayad, Edouard
Zeid, Cynthia Abou
Hajjar, Rayan El
Cabrera, Nicolo L
Radi Abou Jaoudeh, Rasha Abi
Malek, Alexandre E
Affiliations: Faculty of Medicine 
Keywords: Arcanobacterium haemolyticum
Pharyngitis
Systematic review
Tonsillitis
Issue Date: 2021
Publisher: Elsevier
Part of: International Journal of Pediatric Otorhinolaryngology
Volume: 146
Abstract: 
Introduction
Arcanobacterium haemolyticum causes pharyngotonsillitis in children and young adults. It is rarely isolated in pharyngeal swabs as testing for it is not routine. Data on complications, management, and antibiotic susceptibility testing is limited. We sought to review the available literature on the presentation and management of A. haemolyticum pharyngotonsillitis in this age group.

Methods
A systematic review of eligible studies reporting pharyngotonsillitis and related complications in children and young adults caused by A. haemolyticum was conducted. Literature from case reports, case series, and available cohorts was compiled. Data were analyzed using descriptive statistics.

Results
The initial database search yielded 63 articles, after applying exclusion criteria 17 studies were included. 191 patients were identified with a median age of 16.5 years. The most common presentation was throat pain reported in 93.7% of patients. Tonsillar exudates, fever at presentation and rash were present in more than half of the reviewed cases. The diagnosis was established by a positive culture on a pharyngeal swab in 98.8% of swabs collected. Complications described included peritonsillar abscesses, Lemierre's syndrome, pneumonia, and sepsis. Penicillin was the first line antibiotic in 81% of patients followed by macrolides in 19 patients (18%).

Conclusions
A. haemolyticum occurs in children and young adults and may result in complications. Our review supports its susceptibility to penicillin. We suggest a diagnostic and management algorithm to guide clinicians in targeted testing and aid with decision making regarding timely and appropriate antibiotic therapy, in an effort to reduce the burden of its complications.
URI: https://scholarhub.balamand.edu.lb/handle/uob/5266
ISSN: 01655876
DOI: 10.1016/j.ijporl.2021.110759
Ezproxy URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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