Primary bacterial pathogens account for approximately 30% of cases of pharyngitis in children. These include the following:
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GABHS (common)
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Arcanobacterium hemolyticum (7% of adolescents and adults with pharyngitis)
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Group C streptococci (uncommon)
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Group G streptococci (uncommon)
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Neisseria gonorrhoeae (uncommon)
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Corynebacterium diphtheriae (rare)
No pathogen is isolated in nearly 30% of cases, and viruses are isolated in approximately 40% of cases. Other probable copathogens in children include the following:
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Moraxella (Branhamella) catarrhalis
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Bacteroides fragilis
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Bacteroides oralis
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Bacteroides melaninogenicus
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Fusobacterium species
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Peptostreptococcus species
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Chlamydia trachomatis (less common)
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Mycoplasma pneumoniae (less common)
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Posterior pharynx with petechiae and exudates in a 12-year-old girl. Both the rapid antigen detection test and throat culture were positive for group A beta-hemolytic streptococci.
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Streptococcal pharyngitis. Note the redness and edema of the oropharynx and petechiae, or small red spots, on the soft palate caused by strep throat. Strep throat is caused by group A streptococcus bacteria. These bacteria are spread through direct contact with mucus from the nose or throat of persons who are infected or through contact with infected wounds or sores on the skin.