eMedicine Specialties > Dermatology > Bacterial Infections

Arcanobacterium Haemolyticum: Follow-up

Author: Kyle L Horner, MD, MS, Staff Physician, Department of Dermatology, Penn State Milton S Hershey Medical Center
Coauthor(s): Gregory J Raugi, MD, PhD, Professor, Department of Internal Medicine, Division of Dermatology, University of Washington at Seattle; Chief, Dermatology Section, Primary and Specialty Care Service, Veterans Administration Medical Center of Seattle; Kord Honda, MD, Fellow in Dermatopathology, Division of Dermatology, Department of Medicine, University of Cincinnati
Contributor Information and Disclosures

Updated: Sep 11, 2009

Follow-up

Further Inpatient Care

  • Occasionally, a patient who appears very ill with pharyngitis caused by Arcanobacterium haemolyticum (ie, unable to swallow, illness is severe) may require admission for administration of parenteral antibiotics.
  • Admit patients with systemic infections caused by A haemolyticum to administer parenteral antibiotics and manage their infection in a way similar to that of a patient with bacteremia or focal abscess.

Deterrence/Prevention

  • Although epidemiologic contact studies suggest that the disease is spread from human to human, the exact mechanism of spread has not been determined. However, it is not unreasonable to suggest that judicious handwashing and avoiding shared utensils and food may help to prevent the spread of the disease.

Complications

  • Peritonsillar abscess has been reported in 5 patients. The patients presented with severe sore throat and fever (37.3-40.1°C). After drainage, resolution occurred in all patients.33,43,44
  • Sepsis, with isolation of A haemolyticum from blood cultures, has occurred in patients with pharyngitis.45,46,47,48,60

Prognosis

  • The natural course of pharyngitis caused by A haemolyticum is resolution within a few days to 2 weeks.1
  • Antibiotics have been shown to eradicate A haemolyticum from the oropharynx and to resolve symptoms within 3 days.33
  • Whether antibiotic therapy prevents complications in patients with pharyngitis is not known.

Miscellaneous

Medicolegal Pitfalls

  • Failure to clinically distinguish pharyngitis caused by A haemolyticum from scarlet fever is a pitfall. Diagnosis is differentiated by the results of bacterial pharyngeal culture.
 
Acknowledgments

  • The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Richard Miller, MD, to the development and writing of this article.
  • The authors would like to thank Jan Hirschmann for his critical review of this article and Richard Miller, MD, for graciously providing the images.



More on Arcanobacterium Haemolyticum

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Differential Diagnoses & Workup: Arcanobacterium Haemolyticum
Treatment & Medication: Arcanobacterium Haemolyticum
Follow-up: Arcanobacterium Haemolyticum
Multimedia: Arcanobacterium Haemolyticum
References
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Further Reading

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Keywords

, pharyngitis, cutaneous infections, infections, secretive bacteria, pharyngeal infection

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Contributor Information and Disclosures

Author

Kyle L Horner, MD, MS, Staff Physician, Department of Dermatology, Penn State Milton S Hershey Medical Center
Kyle L Horner, MD, MS is a member of the following medical societies: American Academy of Dermatology, American Medical Association, and Pennsylvania Academy of Dermatology
Disclosure: Nothing to disclose.

Coauthor(s)

Gregory J Raugi, MD, PhD, Professor, Department of Internal Medicine, Division of Dermatology, University of Washington at Seattle; Chief, Dermatology Section, Primary and Specialty Care Service, Veterans Administration Medical Center of Seattle
Gregory J Raugi, MD, PhD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

Kord Honda, MD, Fellow in Dermatopathology, Division of Dermatology, Department of Medicine, University of Cincinnati
Kord Honda, MD is a member of the following medical societies: Phi Beta Kappa
Disclosure: Nothing to disclose.

Medical Editor

Robin Travers, MD, Assistant Professor of Medicine (Dermatology), Dartmouth University School of Medicine; Staff Dermatologist, New England Baptist Hospital; Private Practice, SkinCare Physicians
Robin Travers, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Informatics Association, Massachusetts Medical Society, Medical Dermatology Society, and Women's Dermatologic Society
Disclosure: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Managing Editor

Paul Krusinski, MD, Director of Dermatology, Professor, Department of Internal Medicine, Fletcher Allen Health Care, University of Vermont
Paul Krusinski, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

CME Editor

Glen H Crawford, MD, Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital
Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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