A. haemolyticum can cause peritonsilar abscess, pharyngitis and
tonsillitis in teens and adults. The sore throat and difficulty
swallowing occur with both A. haemolyticum and Strep group A. It is
important to differentiate between them because A. haemolyticum is
often penicillin resistant and that is a problem as the standard
treatment for Strep A is penicillin.
One way to differentiate which organism may be the cause is to look
for a symptom that sometimes occurs with A. haemolyticum. 1/2 - 2/3 of
patients show a rash similar to rheumatic fever, but this rash differs
in that it is also on the palms and feet.
I don't think most labs look for this bug because it is nowhere near
as common as Strep A as the cause of infection. I know our lab doesn't
generally look for it. Should it be looked for? Probably, but I think
you'll look for a long time before you find a haemolyticum unless you
culture your daughter yourself if that is the cause. You should have
done that after she didn't get better with the first course of
penicillin just for your own info. Culture her now, before surgery and
look for it yourself.
The colonies of A. haemolyticum look very similar to Strep A. Both are
beta-hemolytic and catalase negative, making identification confusing
for the inexperienced technologist, though a gram stain would reveal
gram positive rods rather than the expected cocci in chains. Without
the smear, I think most would report the organism simply as
beta-hemolytic Strep not A, if it was reported at all. I believe A.
haemolyticum can be identified by various commercial products such as
Vitek GPI or API Cornye, or you can go the good old fashioned route.
Sak
On 10 Mar 2001 00:25:50 -0000, rd-ohl at home.com ("Rhonda") wrote:
>Does anyone know anything about this bacterium? Arcanobacterium Haemolyticum (A. Haemolyticum)
>My 16 yr old daughter is having a tonsillectomy next week and I have a sneaking suspicion this is the cause.
>She started having tonsillitis about a year ago and the diagnosis was Strep A based on observation not on testing. Penicillin in pill form didn't work for her so we proceeded to use Penicillin IM. This went on about every three months. Being an MT specializing in Microbiology I finally decided to do some research myself but all I could find was an older article on Medscape where it was included in an article about Rhodococcus Equi. It indicated that this is a common (?) co-infection in people 15 to 30 yrs who have been diagnosed with Group A or other beta hemolytic streps. Also with Mono, which my daughter also had , confirmed by testing. It says that there are reports of treatment failure with Penicillin and the DOC is Erythromycin. It also says that it must be specifically sought in appropriate specimens to obtain an accurate diagnosis.
>My concern is that we do not routinely screen throat cultures for this organism. I was wondering if any other labs do? And if they do, what documentation they have that I could give to our Microbiologist to convince him we should be.
>As a mother I am upset that this was overlooked and now my daughter has to have surgery instead of a different antibiotic. As a professional I want to do all I can to save other patients from the same fate. Maybe it is all so simple as my GP doc should have known about it and treated her accordingly...they are just human after all...but if it is our mistake by not screening for it I would like to correct that.
>Thanks for your time and in advance for your input. Any comments would be greatly appreciated!
