Throat cultures from an adult pharyngitis patient yielded as a single organism, with a very high bacterial count. The isolate was found to be macrolide and fluoroquinolone resistant, and the same strain was cultured from the patient's denture washing solution. Ceftriaxone therapy, a gradual reduction in the bacterial count and progressive clinical improvement proceeded at the same pace, so we labelled this clinical case as a pneumococcal pharyngitis.


Article metrics loading...

Loading full text...

Full text loading...



  1. Balsalobre, L., Hernandez-Madrid, A., Llull, D., Martin-Galiano, A. J., Garcia, E., Fenoll, A. & de la Campa, A. G. ( 2006; ). Molecular characterization of disease-associated streptococci of the mitis group that are optochin susceptible. J Clin Microbiol 44, 4163–4171.[CrossRef]
    [Google Scholar]
  2. Carbon, C. & Isturitz, R. ( 2002; ). Narrow versus broad spectrum antibacterials: factors in the selection of pneumococcal resistance to beta-lactams. Drugs 62, 1289–1294.[CrossRef]
    [Google Scholar]
  3. Esposito, S., Blasi, F., Bosis, S., Droghetti, R., Faelli, N., Lastrico, A. & Principi, N. ( 2004; ). Aetiology of acute pharyngitis: the role of atypical bacteria. J Med Microbiol 53, 645–651.[CrossRef]
    [Google Scholar]
  4. Gonzales, R., Bartlett, J. & Besser, R. ( 2001; ). Principles of appropriate use for treatment of acute respiratory tract infections in adults: background, specific aims, and methods. Ann Intern Med 134, 479–486.[CrossRef]
    [Google Scholar]
  5. Ip, M., Chau, S. S., Chi, F., Qi, A. & Lai, R. W. ( 2006; ). Rapid screening of fluoroquinolone resistance determinants in Streptococcus pneumoniae by PCR-restriction fragment length polymorphism and single-strand conformational polymorphism. J Clin Microbiol 44, 970–975.[CrossRef]
    [Google Scholar]
  6. Johnston, N. J., De Azavedo, J. C., Kellner, J. D. & Low, D. E. ( 1998; ). Prevalence and characterization of the mechanisms of macrolide, lincosamide, and streptogramin resistance in isolates of Streptococcus pneumoniae. Antimicrob Agents Chemother 42, 2425–2426.
    [Google Scholar]
  7. Reinert, R. R., Luetticken, R., Brysker, A. & Al-Lahham, A. ( 2003; ). Macrolide-resistant Streptococcus pneumoniae and Streptococcus pyogenes in the pediatric population in Germany during 2000–2001. Antimicrob Agents Chemother 47, 489–493.[CrossRef]
    [Google Scholar]
  8. Sakata, H. ( 2005; ). Study of Streptococcus pneumoniae bacteremia in children. Kansenshogaku Zasshi 79, 1–6.[CrossRef]
    [Google Scholar]
  9. Tan, T. Q. ( 2002; ). Update on pneumococcal infections of the respiratory tract. Semin Respir Infect 17, 3–9.[CrossRef]
    [Google Scholar]
  10. Watt, J. P., O'Brien, K. L., Katz, S., Brondson, M. A., Elliott, J., Dallas, J., Perilla, M. J., Reid, R., Murrow, L. & other authors ( 2004; ). Nasopharyngeal versus oropharyngeal sampling for detection of pneumococcal carriage in adults. J Clin Microbiol 42, 4974–4976.[CrossRef]
    [Google Scholar]
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error