PDF(Sci-hub)
Abstract：
BACKGROUND: 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.
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.
摘要：
背景：溶血弧菌可引起儿童和年轻人的咽扁桃体炎。它很少在咽拭子中分离，因为测试它不是常规的。有关并发症的数据，管理,和抗生素敏感性测试是有限的。我们试图回顾有关该年龄段的溶血性咽炎的表现和治疗的现有文献。
方法：对有资格的研究进行了系统评价，这些研究报告了儿童和年轻人由溶血性弧菌引起的咽炎和相关并发症。来自病例报告的文献，案例系列,并编制了可用的队列。数据采用描述性统计分析。
结果：最初的数据库搜索产生了63篇文章，在应用排除标准后,纳入了17项研究.191名患者的中位年龄为16.5岁。最常见的表现是在93.7%的患者中报告的咽喉疼痛。扁桃体分泌物,超过一半的病例在就诊时出现发热和皮疹。诊断是通过收集的98.8％的拭子在咽拭子上的阳性培养物确定的。所描述的并发症包括扁桃体周围脓肿，Lemierre综合征,肺炎,还有败血症.81％的患者使用青霉素作为一线抗生素，19例患者使用大环内酯类药物（18％）。
结论：A.溶血病发生在儿童和年轻人中，并可能导致并发症。我们的评论支持其对青霉素的易感性。我们建议一种诊断和管理算法，以指导临床医生进行有针对性的测试，并帮助做出有关及时和适当的抗生素治疗的决策。以减轻其并发症的负担。
方法：对有资格的研究进行了系统评价，这些研究报告了儿童和年轻人由溶血性弧菌引起的咽炎和相关并发症。来自病例报告的文献，案例系列,并编制了可用的队列。数据采用描述性统计分析。
结果：最初的数据库搜索产生了63篇文章，在应用排除标准后,纳入了17项研究.191名患者的中位年龄为16.5岁。最常见的表现是在93.7%的患者中报告的咽喉疼痛。扁桃体分泌物,超过一半的病例在就诊时出现发热和皮疹。诊断是通过收集的98.8％的拭子在咽拭子上的阳性培养物确定的。所描述的并发症包括扁桃体周围脓肿，Lemierre综合征,肺炎,还有败血症.81％的患者使用青霉素作为一线抗生素，19例患者使用大环内酯类药物（18％）。
结论：A.溶血病发生在儿童和年轻人中，并可能导致并发症。我们的评论支持其对青霉素的易感性。我们建议一种诊断和管理算法，以指导临床医生进行有针对性的测试，并帮助做出有关及时和适当的抗生素治疗的决策。以减轻其并发症的负担。
