Pediatr Infect Vaccine.  2016 Apr;23(1):40-45. 10.14776/piv.2016.23.1.40.

Etiology of Acute Pharyngotonsillitis in Children: The Presence of Viruses and Bacteria

  • 1Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 2Department of Pediatrics, Fatima Hospital, Changwon, Korea.
  • 3Division of Bacterial Respiratory Infections, Center for Infectious Diseases, Korea National Institute of Health, Seoul, Korea.


The purpose of this study was to investigate the etiology of acute pharygotonsillitis in pediatric patients.
Pharyngeal swabs from patients with acute pharyngotonsillitis were evaluated for viruses and bacterial organisms from March 2010 through March 2011.
Of 615 patients, potentially pathogenic bacteria were isolated in 40 (6.5%), viruses were isolated in 310 (50.4%), and no pathogens were isolated in 267 patients (43.4%). Both viral and bacterial pathogens were found in 2 (0.3%). Of 40 patients with bacterial pathogens, group A streptococci were found in 31 (77.5%). Among 310 patients with virus infection, adenovirus was the most frequently recovered (203 patients; 65.5%), followed by rhinovirus (65 patients; 21.0%), enterovirus (43 patients; 13.9%) and coronavirus (18 patients; 5.8%). There were 25 patients who had been coinfected with 2 viruses. In viral pharyngotonsillitis, cough, rhinorrhea, conjunctivitis and diarrhea were prominent. On the other hand, pharyngeal injection and pharyngeal petechiae were prominent in bacterial pharyngotonsillitis.
Virus infection was a big part of acute pharyngotonsillitis and there were differences in clinical manifestations among viral and bacterial infections. Therefore, we need to distinguish between virus infection and bacterial infection using clinical signs for preventing the abuse of antibiotics.


Acute pharyngotonsillitis; Children; Etiology
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